Contracting Intake Form

Agent Name(Required)

Your Organization(Required)

NPN #(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Fixed Indexed Annuity (FIA) Annual Premium(Required)

$0-500k

$500-2m

$2-5m

$5m+

Target Life Insurance Annual Premium(Required)

$0-50k

$50-100k

$100-250k

$250+

What insurance carriers are you currently using?(Required)

Do you have any questions?(Required)

Kyle Pesch

View Profile
James Jacobson

View Profile
Kayden Meyersick

View Profile
Windy Nash

View Profile
Chase Koester

View Profile
Lauren Edwards

View Profile
Stephanie Smith

View Profile
Tiffany Nicely

View Profile
Brandon Olson

View Profile
Dalton Sneed

View Profile

Contracting Intake Form

CONTACT US

CONNECT WITH QUANTUM

Kyle Pesch

James Jacobson

Kayden Meyersick

Windy Nash

Chase Koester

Lauren Edwards

Stephanie Smith

Tiffany Nicely

Brandon Olson

Dalton Sneed

Contracting Intake Form

CONTACT US

CONNECT WITH QUANTUM

Kyle Pesch

James Jacobson

Kayden Meyersick

Windy Nash

Chase Koester

Lauren Edwards

Stephanie Smith

Tiffany Nicely

Brandon Olson

Dalton Sneed

Kyle Pesch

VP of Advisor Development

James Jacobson

Director of Strategic Accounts

Kayden Meyersick

Director of Business Development

Windy Nash

Senior Account Manager

Chase Koester

VP of Life & LTC Insurance

Lauren Edwards

Senior Account Manager

Stephanie Smith

Senior Account Manager

Tiffany Nicely

Senior Account Manager

Brandon Olson

Director of Business Development

Dalton Sneed

Director of Business Development