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* Position: Independent Agent Captive Agent Semi-Captive MGA/BGA Other : If you chose MGA/BGA, number of agents:   * Check all the products you or your agents regularly sell:   Permanent Life Insurance Term Life Insurance Fixed Annuities Variable Products Individual Health Group Health Disability Income Long Term Care Final Expense Medicare Supplement Supplemental Products Mutual Funds, Stocks or Bonds Index Annuities Other : Markets you currently target or plan to target:     Current   Planned                   Senior Market             Business Market             Associations             Financial Planning             Affluent Market             Mortgage Protection             Boomer Market             Other : Professional designations/licenses:   CFP CLU ChFC RIA LUTC RHU CSA P&C Series 6 Series 7 Other : Years In life/health business:   1 - 5   6 - 10   11 - 20   21+   Number of companies represented:   1   2 - 5   6 - 10   11+   Expected annual commission/override income:   Under $50K $50K - $100K $100K - $200K $200K - $300K Over $300K Your request for a subscription to this magazine is also your consent to allow us to contact you by telephone, fax, email, U. S. Mail or other means for possible renewal of your subscription or third party communications