Broker Facilities

BECOME A BROKER

If you would like to become a Broker with MG Insurance Consultants, please complete the details below.

Please Note: You must be registered with the F.S.A. and carry professional Indemnity Insurance to become an MG Insurance affiliate.

PI Insurance Details

Your F.S.A. number*
Your Insurer*
Policy Number*
Limit of Indemnity*
Renewal Date*	(Format: dd-mm-yyyy)

Your Details

Broker Name:*
Contact Name:*
House Name / No:*
Address 1*
Address 2
Town/City*
County*
Country*
Post Code:*
Telephone:*
Fax:
Email:*

Terms and Conditions Of Agreement

Please read the MG Insurance Terms and Conditions Of Agreement here (opens in a new window). By completing this form you are agreeing to our Terms and Conditions. If you do not accept and agree fully to all the Terms and Conditions Of Agreement, do not complete this form.

* I acknowledge that I have read the MG Insurance Terms and Conditions Of Agreement. I understand them and agree to them.

MG Insurance Consultants Limited, Staley House, Hassall Street, Stalybridge, Cheshire. SK15 2LF