2018 Producer Academy Application

Featuring high-caliber, tailored training by the International Foundation of Employee Benefit Plans (IFEBP), the 2018 UBA University Producer Academy is a comprehensive, high-octane, six-month training program that covers everything from tactical knowledge to industry analysis.

First Session: February 20 - March 2, 2018, at the Bohemian Hotel Celebration in Orlando, Florida
Second Session: May 6-8, 2018, at the Renaissance Schaumburg Convention Center Hotel in Schaumburg, Illinois
Third Session: September 16-18, 2018, at the Swissotel Chicago in Chicago, Illinois

Cost: $5,000 inclusive of Orlando hotel, select meals, and education.

There is a maximum capacity of 25 students. A wait list will be kept for all additional requests. If you have further questions regarding registration for the Producer Academy, contact Christine Rogers at crogers@ubabenefits.com.

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* 1. Applicant

Name *

Company *

Address *

Address 2

City *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

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* 2. Title

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* 3. Birth Date

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* 4. Total years in the insurance industry?

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* 5. Total years in general sales?

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* 6. Insuranse licence number

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* 7. Licensing state

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* 8. Current revenue of book of business

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* 9. Who from your Firm is sending you to the Producer Academy? (name of Sales Manager, Principal, etc.)

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* 10. Do you have a sales goal?

Yes

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* 11. If Yes, what is your sales goal?

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* 12. Payment Options:

Payments in full: $5,000

$500 deposit with six monthly installments of $835

Monthly installments will be due on Oct. 31, 2017, Nov. 30, 2017, Dec. 29, 2017, Jan. 31, 2018, Feb. 28, 2018, and March 30, 2018.
Please send payment to: United Benefit Advisors, 1 Pierce Place, Suite 400E, Itasca, IL 60143

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* 13. Today's Date

Date

Refund Policy:

At UBA, we understand that the unexpected can happen. We offer the following refund policy.

Requests received before October 31, 2017: 100% refund.
Requests received before November 30, 2017: 50% refund.
Requests received before December 29, 2017: 25% refund.
No refunds will be given after December 31, 2017.

* In the event UBA is able to locate someone to take the place of your applicant before the start of the first session, UBA will refund 100% of your investment .

All requests for refunds must be made in writing by a Firm Principal and sent to John Behn at jbehn@ubabenefits.com.