To receive more information on a career with Lincoln Heritage Life Insurance Company, please complete and submit the form below.

Submit Recruiting Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone Number (Daytime):
Phone Number (Evening):
Best Time To Call: A.M. P.M.
E-mail address:
 
How did you hear about us? Magazine:
Flyer / Mailer:
Newspaper:
Internet:
Email:
Referred By:
Other:
 
Are you currently licensed? Yes
No
 
Do you conduct business: As a personal producing GA
Through a funeral home
As an independent agency with agents.
As a broker agency with brokers.
Other:
 
Do you speak Spanish?
No