YAC Frank H. Furman Scholarship Application

The Florida Association of Insurance Agents Young Agents Council was created in 2006 to give young agents, and those new to the field, the leadership and professional skills needed to practice their craft and perpetuate the Independent Agency System. Membership is open to all FAIA members, licensed or not, who have been in the business fewer than 10 years or are younger than 40.

Please fill in the information requested below. Fields with an * are required.
*Agency Name  
*Name:  
*FAIA Member ID  
*Date of Birth  
*Address  
*City  
State
*Phone  
*Email    
*Insurance License Number:  
*Year You Received License:  
*What are you most looking forward to as a Young Agent (example: getting involved in the legislative process; networking; increased community involvement)?:  
*Where do you see yourself in 10 years?  
Submit