Amount Paid : $299.00

Independent Agent Agreement

Enrollment Information


First Name
Middle Initial (Optional)
Last Name
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Address
APT / SUIT (Optional)
City
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Zip Code
Email
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Cell Phone
DOB
SSN

Membership

Information

Password
Conf. Password

Payment Information

Enter your card information:
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Card Number
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CVV

Language

Agent Information

Agent ID :  520758

Agent Name :  Donmaid Brooks

Commission

I understand that until I enroll in direct deposit through the form in my UWE Back Office, I will receive my commission via check.*

*I understand that a $4.00 processing fee will be taken from each weekly commission check payment.

Term & Conditions

I consent to the use of electronic records and have read, understand and agree to the United Wealth Education Services/YFL IR Agreement Policies and Procedures: