/* Styling for Tablets */@media only screen and ( max-width: 800px ) and ( min-width:481px ) {}/* Styling for phones */@media only screen and ( max-width: 480px ) {}/*Option to add custom CSS */lang="en-US"> Application to Become An Agent - Tech Minded
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Application to Become An Agent

Become an Agent

Want to know more? Sign up to be an Agent for Tech Minded. Simply fill out the form below, and we'll get you more information.

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    This is an internally used ID. It won't be known by the user, and needs to be filled in post-contract, before creating the user.
  • What is your title?
  • What would you like your login name to be?
  • To speed the process along, by checking "Yes", you are requesting we reach out to you to answer any questions, as well as to create an Agent agreement (for which you have no obligations to until you sign). The information that you provide below will allow us to quickly generate an Agent agreement for you to digitally sign. This agreement gives us the ability for you to tap into all the channels we have (and most of the agreement terms are there so that you can be under our provider agreements).
  • This is the type of Tech Minded member you are requesting to be.

  • Information We Need to Proceed

  • Help Us Know You

    The next few questions help us to know a bit about you and what you do -- it speeds the process along.
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  • Social Media for You/Your Organization

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