Welcome to the Movement — Main Street Financial Services

About you

First name *

Last name *

Email *

Mobile phone *

Date of birth *

What happens after you submit

Here's exactly what to expect — no need to call and check.

We send your contracting links.You'll get your carrier contracting and appointment paperwork to complete (including E&O confirmation).

We submit to the carrier.Once you've completed everything, we submit your contracting to the insurance company.

Writing numbers arrive.It typically takes 5–10 business days to receive your writing numbers with those carriers.

You sign our agent agreement.We then send our agent agreement outlining the program for your signature — if you choose to come aboard.

How would you like to come on?

This tells us which track to set you up on.

Full-time agent — no stipendStraight commission from day one. Agent with the Stipend ProgramQualify, then earn the $2,000/month stipend for 12 months. Recruiter — building toward DirectorBuild and lead a team on the path to the Director position.

Who recommended you?

Lead Program interest

Your tier is set by production — this just tells us where you're starting.

Starting out · Under $10,000 APFull Lead Program — $250/week. 50 warm leads + 5 set appointments. Producing · $10,000+ APWe share 50% of your lead cost — you pay $125/week. Top producer · $15,000+ APWe pay 100% — $0 out of pocket. Not sure yetHelp me choose during onboarding.

Errors & Omissions (E&O)

Do you carry E&O coverage? *

E&O carrier (if active)

Confirm & sign

I confirm the information above is accurate and complete to the best of my knowledge. * I understand all compensation, bonus, stipend, and income figures are projections, not guarantees, and that results vary by effort, production, and carrier approval. * I authorize verification of my insurance license, E&O, and background as part of the onboarding and carrier-appointment process. * I agree to be contacted by Main Street Financial Services / Bankable Equity by phone, SMS, and email regarding my application and onboarding. *

Type your full legal name to sign *

Date *

Typing your name acts as your electronic signature on this application.

✓

Application received

Welcome to the movement. Watch your email — next, we'll send your contracting links to complete. Once submitted to the carrier, writing numbers typically arrive in 5–10 business days, and you'll get your welcome letter with your personal Agent Education Link.