Order
Retail Clients Corporate Clients
AGENT REGISTRATION APPLICATION
City of inhabitancy *
Name Surname *
Age
Education *
High economic
High technical
High legal
High pedagogic
High linguistic
Secondary
Other
Do You have work experience in the sphere of insurance?
No
Yes, as an agent
Yes, as an employee
Do You have experience in communication with client? *
No
Yes, as a product seller
Yes, as a service provider
Yes, as a service centre employee
Do You know how to use computer? *
No
Yes, for personal use
Yes, for business use
What are You doing at present? *
Your e-mail address *
@
Your telephone number *
Your telephone number
Your mobile number

* All fields marked with asterisk are mandatory for filling.

*/

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In case of disparity between information presented in Armenian, Russian and English the Armenian variant is preferable.