Entrepreneurial Agent Referral Form

REFER AN EA CANDIDATE. EARN $5,000.

Complete the form below to help AAA recruit new insurance agency owners. You can earn a $5,000 referral fee.

To receive your award, the candidate you’re referring must officially open an EA office, and your on-line candidate referral form must be received and receipt confirmed by the Company, specifically EA Support, prior to the official EA office opening. Referral awards will be processed within 60-days after the official office opening date.

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Your Candidate's Contact Information

* Required

First Name:

*

Last Name:

*

Street Address:

*

City:

State:

Zip Code:

Phone Number:

*

Alternate Phone:

*

E-mail Address:

*

Your Contact Information

* Required

First Name:

*

Last Name:

*

Street Address:

*

City:

*

State:

*

Zip Code:

*

Phone Number:

*

E-mail Address:

*

Terms and Conditions

A $5,000 award will be paid for each EA referral that results in an appointment and an EA office opening in one of the following states: Michigan, Minnesota, Illinois and Wisconsin. Additional states may be added at the company’s discretion based on marketing needs.
Referral bonus subject to change at company's discretion.
All referrals must be submitted online using the Entrepreneurial Agent Referral Form available at AAA.com/YourAgency. Nominators can submit an unlimited amount of referrals.
When a referral form submission is received, an email confirmation is automatically sent to the nominator and the company. The referral form is stored in the company database.
All referral awards are approved by the EA Initiative Support team and payments are processed by Corporate Disbursements.
Award recipients will receive an official notification via mail along with the appropriate tax documentation (W-9) to complete prior to receiving their award. Award recipients will receive a check for their award and 1099 tax statement according to IRS tax regulations.
All awards will be processed within 60 days after EA office opening. In case of disputes, the final award decisions will be determined by ACG management.
All ACG employees must follow the company-approved EA Referral Award Program procedures administered by Human Resources.
EA Principals currently appointed by ACG and their office staff must follow the company-approved EA Referral Award Program procedures administered by EA Initiative Management.
No awards will be paid for referrals for current employees or anyone associated with the administration and/or management of the EA Initiative or Independent Agent program.
No award will be paid for a former ACG employee or someone currently or formerly employed at or engaged by ACG as a temp, co-op, intern, contractor, subcontractor, consultant or any other service provider.
No awards will be paid to any ACG recruiters or recruiting organizations used by ACG for the purposes of identifying potential EA candidates.
No awards will be paid for self referrals.
Candidates already known to ACG are not eligible for a referral reward. A “known candidate” is defined as someone who has petitioned for an EA appointment with ACG within the past 12 months. After 12 months, the candidate would no longer be considered “known” and would become eligible to be referred through the award program.
The terms and conditions of the EA Referral Award Program are subject to change based on the company’s discretion.

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