LEAD with Comp Registration

Please answer the following questions regarding your registration for LEAD with Comp, in full. If you have any questions regarding the specific questions being asked, please don't hesitate to contact us at AgentTraining@AFGroup.com.

Participant's Full Name *This question is required.

Participant's Job Title *This question is required.

Email Address *This question is required. This question requires a valid email address.

Direct Phone Number *This question is required. This question requires a valid number format.

Please indicate the level of your insurance experience *This question is required.

< 1 Year	1-3 Years	3-5 Years	5+ Years
< 1 Year	1-3 Years	3-5 Years	5+ Years

On a scale of 1 to 10 (1=No knowledge, 10=Expert) how would you rate your level of comfort and knowledge on workers' compensation? *This question is required.

No knowledge

Expert

Current Knowledge Level

1. I understand the cost of the program is $3,500 (early bird registration offering $750 discount by June 1st and $350 discount by June 30th). *This question is required.

2. I acknowledge that myself or my agency is responsible for covering the cost of transportation (airfare or other) to the in-person event in June of 2022. AF Group will cover ground transportation, meals and lodging during the event. More details to come.

Do you have any dietary needs for the June 2022 wrap-up and graduation event? (Please explain if "Yes".) *This question is required.

LEAD with Comp Registration - July 2021

Individual Registration Information