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If you placed $50,000 or more in First Year LTCi premium in 2002, it’s time to get the acclaim and recognition you deserve.

National LTCi Sales Achievement Award™
presented by LTCi Sales Strategies magazine

I would like to apply for the National LTCi Sales Achievement Award. All information is confidential (see Verification Options below). Information will NOT be sold or shared.

First Name:
Middle Initial
Last Name:
Company / Agency Name:
Address:
City:
State: Zip:

Phone:
Email:

2002 Placed LTCi Premium
$ First Year: Actual or Best Est.
2002 Number of Covered Lives

PROOF OF PRODUCTION VERIFICATION:
Career agents can provide a company-produced production report (mail to address below or fax to 818-597-3206).

Brokers can submit the Name and E-mail of their General Agent or the names of up to 3 primary insurers where LTCi business is placed. We will verify separately without providing premium numbers provided.
Primary Company
Secondary Company
Secondary Company

Optional: Your General Agent can verify production for purposes of the Award.
Name of General Agent
GA E-mail Address

Yes    No     Send me Registration information for the National LTCi Producers Summit, Nov 16-18 in New Orleans. Awards will be presented at the Summit.

Listing in Sales Strategies
Yes    No     I give permission for my Name and Award Level to be published in Sales Strategies magazine. Production amounts will not be published. (Summit attendance required)

I certify that the information provided is accurate to the best of my knowledge. I agree that Sales Creators may verify my production numbers on a confidential basis with each carrier listed above.

Or Submit By Mail. Print, Complete and Mail to:
Sales Creators, 3835 E. Thousand Oaks Blvd., Ste 336, Westlake Village, CA 91362

Confidentiality - We take it seriously.
We are committed to ensure that your
private details remain private.
The information you provide will only be used for the purpose of award verification. We guarantee that we will not share and/or sell your name or this information with any other organization. Recipients will only be listed as Platinum, Gold or Silver award recipients.

Best of the Best:
The USA's top 100 producers

Platinum:
Sales Over $250,000
and 100+ covered lives

Gold:
$100,000 - $249,999
and 75 covered lives

Silver:
$50,000 - $99,999
and 36 covered lives