Sportscover Registration

Registration Form for a New Broker

To become a Sportscover Accredited Broker, there are a number of criteria that your company must fulfil including areas such as Information Technology, Complaints Procedures, Geography, Credit history and References. Please complete the following registration form to be submitted to the Underwriting Panel for consideration.

Completion of this form is an Application only and does not guarantee accreditation.

 
Broker Details
Broker Name  
Contact Name  
Email
     
Telephone (Home)
Telephone (Business)  
Fax
Website
   
   
Broker Address
Address Line 1  
Address Line 2
Town/City  
State/County/Province  
Postcode/Zipcode  
Country  
   
Contact Address
 
Address Line 1  
Address Line 2
Town/City  
State/County/Province  
Postcode/Zipcode  
Country  
   
Business Information
Broker Member Are you a memeber of a broker group?  
 
Sports & Business What Sports and leisure business do you currently have?

 
 
Sports & Business
Outlook
What Sports and leisure business are you targeting in the next 12 months?

 
   
Verification Code
  New Code