1. Personal Details
Full Name As Per Id

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Agent Code

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Agency Code

-

Agency Name

-

Marital Status*
Spouse Details
Full Name As Per ID*
Identification Type*
Identification No.*
Nationality*
Passport Expiry Date*
Please enter a valid Passport Expiry Date.

2. Licence
Please select licence type to add.
 
Documents*

Please select the file and tap on upload button. Supported file types: .jpg, .png, .pdf up to 10 MB.

      Documents*

      Please select the file and tap on upload button. Supported file types: .jpg, .png, .pdf up to 10 MB.

          Documents*

          Please select the file and tap on upload button. Supported file types: .jpg, .png, .pdf up to 10 MB.


              3. Upload Document

              Please upload all mandatory documents below and ensure your details are correct before submitting your application. Please select the file and tap on the upload button. Supported file types: .jpg, .png, .pdf up to 10MB

              COPY OF ID (FRONT)*

                  COPY OF ID (BACK)*

                      Passport Sized Photo*

                          1. Copy of ID (Front)*

                          Front copy of your Identity Card (e.g. IC)

                          2. Copy of ID (Back)*

                          Back copy of your Identity Card (e.g: IC)

                          3. Passport Sized Photo*

                          Please refer to Guidelines for photo requirements.

                          MOVEMENT OF AGENT

                              RESIGNATION LETTER

                                  4. Movement of Agent

                                  Applicable if candidate is attached with other insurer company

                                  5. Resignation Letter

                                  Applicable if candidate is attached with other insurer company


                                  4. Contract

                                  Please select licence(s) before proceeding.

                                  LIFE-CEILI does not require a contract.

                                  Click on the link below to sign contract(s).


                                  5. Declaration

                                  Please select licence(s) before proceeding.

                                  Click on the link below to sign declaration

                                  Please ensure all mandatory fields are completed correctly before submitting your application