Sterling Partnership Appllication

Instructions

Thank you for your interest in a Sterling Partnership with PIA Western Alliance!

Please select your Sterling Partnership level and then scroll down to complete the online application.

The top portion of the form (Individual Information) should include contact information for the primary contact person. The Business Information portion of the form should include the general contact information for the company (if different from the Individual Information). Please select the state(s) you represent that corresponds with the number of states from your partnership level from the dropdown menu.

Please confirm that your contact information is accurate (with correct spelling and punctuation) prior to submitting your application. Once application is received, we will review and contact you if there are questions. When approved, your credit card will be charged and you will receive a confirmation email and receipt. If you wish to pay by check, please select "Invoice Me" at the bottom of the form .

Please contact us at (888) 246-4466 if you have any questions!

Select Your Option(s)

Sterling Partnership Price of Level Selected (Price Range: $1500 - $8250 Once Per Term)

Select Level

Membership with PIA directly supports the independent agency system through PIA's legislative advocacy. In return, PIA has numerous ways to benefit your company with our Branding and Marketing program that reaches more than 12,000 independent agencies in 10 western states. Discover how your company can benefit as a Sterling Partner with PIA Western Alliance.

Sterling Partner Benefits:

Your company logo displayed on our website homepage
Dedicated company page on PIAWEST.COM website
Your Company logo featured on each applicable state web page joined & linked back to your dedicated webpage
2 Social Media posts twice annually
2 free PIA hosted webinars for CE or 1 CPIA Module. Share with your best agent or colleague.
Member discounts for exhibiting or attending PIA events
Member discounts for PIA's Continuing Education series or CPIA
Legislative advocacy with grassroots messaging
Host 2 of your best agents at a state or regional event
1 free CPIA course annually, share with your best agent or colleague
Your Company logo featured on each applicable state web page joined & linked back to your dedicated webpage
Monthly mailings to include our Sterling Partners
Your approved marketing flyer (sent to us) and included in our Member Kits
Contribute an article to our bimonthly eMagazine InsureIntel
Your logo included on signage at PIA events

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist