BJFIM/Paradigm Insurance Marketing
6800 Owensmouth Avenue Suite 410
Canoga Park, California 91303
Tel: (818) 883-8700 x201 Fax: (818) 883-9036
Email: info@paradigmins.com
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Registration Form
* requred fields
Please tell us about yourself and your business. You will choose a password, which will give you immideate access to research, quoting capabilities, sales tips and tools, access to our group marketing programs, and support in using our acclaimed, innovative approach to faster, more focused selling.
First Name: *
Last Name: *
Company:
Phone #: *
Fax #: *
E-mail: *
Address: *
City: *
State/Zip: *
Ins. License and state: *
Please check each of your professional designations:
CLU
RHU
LUTCF
ChFC
CEBS
CPA
Other
Are you already doing business through us? Yes No
On which markets do you usually focus (check all that apply):
Individual Health
Individual Life
Medicare Risk / Medicare Supplements
Other Senior Products
Business Owners
Small Group (2 - 50)
Mid-Market Group (51 - 500)
Large Group (500 + employees)
Financial Planning / Investments
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Copyright © 2006 Barry J. Fisher Insurance Marketing, Inc., is a registered trademark of Barry J. Fisher. All other names and terms in this release are trademarks or registered trademarks of their respective companies.