We are excited to have you as a new Bridgepointe Strategist! To help complete your profile, please verify the information we have in our system today and provide the additional information requested below. If you have any questions, reach out to gjacobs@bpt3.net.

Agency Name

Strategist Information

First Name

Last Name

Personal/Other Email

Phone Number

Personal/Other Phone

Address Information

Street Address

City

State

Country

Zip/Postal Code

If there are any additional contacts within your company that you would like to have added to our distribution list or who will engage with our team, please add them below.

Are there additional agents/employees that work within your company?

Additional Contacts

First Name

Last Name

Phone Number

Title

Which BPT messages/emails should they receive?

What emails should they not receive?

Please add at least one Emergency Contact. You can add more if you’d like.

Emergency Contact Information

First Name

Last Name

Phone Number

Relationship

Add Another Emergency Contact?

Yes

Emergency Contact #2

First Name

Last Name

Phone Number

Relationship

Additional Information

Shirt Size

Birthday

If you do not wish to provide year, select the current year (2022)

Contact Information