Become an Agent

How did you hear about Wayne Cooperative?*

• Recommended by another agent/group member
• Lost a policy/client to another agent representing Wayne Cooperative
• Client request
• Other

Do you have E&O coverage with at least $1,000,000 limits?*

• Yes
• No

Have you had any E&O claims in the last 3 years? If yes, please describe.*

• Yes
• No

Are you a member of any cluster group arrangements? If yes, please list the group name.*

• Yes
• No

Do you currently have a perpetuation plan in place?*

• Yes
• No

Have you been terminated with any carriers in the last 3 years?*

• Yes
• No

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