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Last Name*
First Name*
Email*
Company
Job Title Bus. Ph.
Home Ph*
Mobile Ph*
Fax Address*
City*
State*
Zip*
Are you a United States Citizen or Permanent Resident that can work for an employer?*
If accepted, when would you like to begin the process of starting our agency program?*
Describe what annual income you consider "High Income"*
If you are considered for an agency, our investment in you would be about $40,000. Tell us why we should invest our capital into your business.*

Tell us about your concerns with starting this new career.*

What advantages do you see in owning your own business?*

Tell us why you are considering a career change, and a possible change to the insurance industry.*

To what do you attribute most of the successes you have experienced in life?*







 


 

* Agents registered with and securities offered through Farmers Financial Solutions, LLC 30801 Agoura Road, Bldg.1 Agoura Hills, CA 91301 (818) 584-0200
 Announcements
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Special Guests:
Jerry Dulik, Vice President of Real Estate
John Lindemann, Division Marketing Manager
Sheldon Chaffer
Careers@Chaffer.com
ph: (760) 360-3984
fax: (760) 874-0335
77-750 Country Club Dr. Ste. E
Palm Desert, CA 92211
Sheldon Chaffer
Registered Principal
Farmers Financial Solutions, LLC
30801 Agoura Road, Bldg.1
Agoura Hills, CA 91301-2054
P.O. Box 6025
Agoura Hills, CA 91376-6025
(805) 306-3400 Member NASD
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 Downloadable Documents
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IconAgent Application