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Applications

    Here you will find several links to both online and printable applications, forms, and documents for several insurance carriers. For applications, forms, and documents for other carriers not listed here please call us at (800) 442-4724 and we will be happy to assist you. You may also contact us with any questions you may have regarding these documents and how to fill them out properly. Any applications printed and filled out using these links must be sent to SCI & Associates via mail for reviewing and processing of the applications. This will help expedite the process of getting approved and receiving the earliest effective date. The address to send the application is as follows:

                    SCI & Associates
                28073 Smyth Dr.
                Valencia, CA 91355

        You may also fax the application with a cover sheet, Attn: Terry Di Donna, to (661) 702-1077. Again if you have any questions about filling out these applications do not hesitate to give us a call. We will gladly answer your questions! Our knowledgeable and licensed staff will make sure that your application is filled out correctly.

 


Online

    The following links will open up a new browser window and send you either to Steve's, Wayne's, or SCI & Associates online applications. Here you will be able to apply for insurance directly through the carrier online.

 


Printable

        All of the following links will open up in a new browser window. These links will lead to you to Adobe PDF files in which you can save, print, then fill out the application. Click here and follow the instructions on how to save, print, and send the PDF files via email, fax, or mail.

SCI Applications:   SCI Option 1 Application
                                      SCI Option 12 Application

Steve's Applications:   Steve's Option 1 Application
                                            Steve's Option 12 Application

Wayne's Applications:   Wayne's Option 1 Application
                                               Wayne's Option 12 Application

    The Following link will lead you to a page that will have all the major insurance carriers applications for you to save, print, and fill out. Again, if you have any questions we can be reached M-F 8:30 am to 5:00 pm at (800) 442-4724.

Printable Enrollment Applications

 

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Last modified: 11/13/06