Introduction If your firm is an insurance broker/intermediary, appointed representative, MGA or risk manager and you would like to take advantage of BIBA member benefits then please complete the following form. If you are interested in becoming an insurer Partner, Affiliate or Associate member of BIBA then please contact us on 0344 7700 266. Company Information Company Name * Trading Name Enter Postcode to search for your company address Address * Street Address Line 2 Street Address Line 3 Town County Postal Code * Main Phone Number * Fax Number Company Email Address Website FCA Regulation: Please note that BIBA will only accept new membership applications from firms that are either FCA authorised or have applied for FCA authorisation FCA Number Type of business * - Select -Sole TraderPLCGeneral PartnershipLimited CompanyLimited Liability CompanyLimited PartnershipLimited Liability Partnership General Insurance Staff Total number of staff * Company Classification * - Select -IntermediaryMGAOtherRisk ManagerBrokerage Would you like to add a branch? Any branches added will be included on the BIBA website 'Find Insurance' page. Yes No Other business address Do you have any associated companies? e.g. if you would like to include an Appointed Representative to your membership please add details here. Any additional staff numbers should be included in the Total staff and General Insurance staff boxes above. Yes No Associated company details Has the company ever traded under a different name? Yes No Please provide details Reasons for Joining Support BIBA lobbying with UK regulator & government Compliance & Technical Support Access to schemes/facilities BIBA conference Networking Online resource Find Insurance Service lead generation BIBA logo Other Do you belong to another trade, educational, professional body or marketing group? 1Answer BrokerDrive Ass of Medical Ins Intermediaries Ataraxia Brokerbility CETA Cobra Network Compass Coversure Members Dart Compliance Ex RWA Hedron Network Hedron Network (disc) Labyrinth Midland Broker Alliance Momentum Broker Solutions Movo Partnership N2Network Ten Insurance Services Ltd The Broker Network (Advantage) The Broker Network (Premier) The General Network UKGI UNA Willis Commercial Network Yorkshire Broker Alliance Special Interest Groups in network Other Trade Body About your Business + Are you a Chartered Broker? * Yes No Company revenue/turnover * - Select -0 - £500k>£500k - £750k>£750k - £1m>£1m - £1.5m>£1.5m - £2m>£2m - £2.5m>£2.5m - £3m>£3m - £3.5m>£3.5m - £4m>£4m - £5m>£5m - £6m>£6m - £8m>£8m - £10m>£10m - £15m>£15m - £20m>£20m - £30m>£30m - £50m>£50m - £75m>£75m - £100m>£100m Do you deal in Personal/Commercial lines or both * - Select -Commercial LinesPersonal LinesBoth Personal & Commercial Lines What % of your business is commercial lines? % Do you wholesale? Yes No What % of your commission & fee income is from wholesale? % Do you trade online? * Yes No Software Provider - None -ActurisOpen GISSPCDLInsurecomOtherTransactorDurellApplied Systems Next Page >
