Agent Enrollment

Become an Agent Today!

We appreciate your interest and we look forward to you becoming part of our team! If you have any questions about becoming an agent, please contact your manager.

Step 1: Please fill out as much information as possible and respond to all questions

Personal Information

Mr.Mrs.Ms.Miss
First Name

MI
Last Name
Social Security #
- -
Date of Birth
Email Address
Verify Email Address
Drivers License Number
Drivers License State

Business Information

Select Tax Type:
Individual/Sole Proprietor C Corporation S Corporation Trust/Estate Partnership Other Limited Liability Company
LLC Tax Classification Required if Limited Liability Company is selected.
Business Name
Employer Identification Number
Business Address
Business Address 2
City
State

Zip/Postal Code
Business Phone
- -
Business Mobile
- -
Business Fax
- -
*For more information on providing a correct Taxpayer Identification Number (TIN) please refer to the W-9 link

Resident Information

Resident Address
Resident Address 2
Resident City
Resident State

Zip/Postal Code
Home Phone
- -

Miscellaneous - Information

Manager Name
Primary mailing address:
Business Address Residence Address

Payment Distribution - Commissions

Commission Type
Advanced As Earned
Commission Code
Financial Institution
Routing Number
Confirm Routing Number
Account Number
Confirm Account Number
Account Type
*You may want to confirm Routing or ABA number with your bank for direct deposits.

I would like to receive my commission dollars in the form of a printed check instead of Direct Deposit.

Returning Agents

If you were a TeamCorp agent in the past, enter your AgentID here: OR I forgot my AgentID

If you have any questions please contact Agent Services at 800 237-1910,
Monday – Thursday 8AM – 5:30PM Central time and on Friday 8AM – 1PM Central time.

CONTACT