Work With Us

Thank you for your interest in becoming an appointed agent with Convelo Insurance Group. To initiate the appointment process please complete the required forms below and return to We will begin processing your request to become an agent and will contact you to complete the process within 48 hours.
If you have any questions, please feel free to contact us at 833-CONVELO.
Please complete, sign and return the following:
  • Copy of your Agency Resident and Non-Resident Agency License(s)
  • Copy of Resident and Non-Resident Agent License(s)
  • Copy of Surplus Lines Resident and Non-Resident Agent License(s) (if applicable)
  • Copy of your E & O Policy Declarations Page
  • Completed Confidential Producer Profile
  • Completed Agency W-9
  • Convelo Broker Agreement

Ready to be a Convelo Broker/Agent? To initiate the quick process, please complete the forms below, attach files and click Submit.

Step 1

Please complete and sign the following forms:

pdfProducer Application


pdfProducer Agreement

pdfDirect Deposit Authorization

Step 2
No files Attached