Become a Caledon Broker | Caledon MGA Insurance UK

Broker Application form

Thank you for your interest in Caledon MGA. Please provide the additional information to assist us in setting up your agency.

N.B. All fields marked * are mandatory.

Your Household Book

Company name including Trading Names/Styles *

Approximate annual Household & Contents Written Premiums (€) *

Which other providers do you use to place your non-standard home business with?

Important Contact Information

Contact Text

Please complete the information on these important contacts in your company to help us with onboarding.

Main contact name *

Main contact position / title *

Main contact telephone *

Main contact email *

Accounts contact name *

Accounts contact position / title *

Accounts contact telephone *

Accounts contact email *

Use this email to send account statements to *

Yes

Account Statements contact name

Account Statements contact position / title

Account Statements contact telephone

Account Statements contact email

Personal Lines Manager/Household Manager Contact

Contact position / title

Contact telephone

Contact email

Access to the Caledon Quote Portal

Access Text

Please complete the details of anyone else who needs system access in the following format (one person per line): Firstname Surname, name@email.com, Job Title, Telephone (ideally DDI)

Access Personnel

Additional Company Information

Additional Text

Please provide us with this additional company information to provide us with insight on how we may be able to help you in the future.

Are there any products or particular areas of the insurance market that you specialise in?

Are there gaps in your product range that you're keen to fill?

Please share the main sources of your new business enquiries.

Declaration and Data Processing (GDPR)

Authorise *

I/We Submit this application for the appointment of intermediary facilities with Caledon MGA. and authorise Caledon MGA to contact any individual or entity whose name has been provided in the application for the purpose of verifying the accuracy of the information and the applicants' suitablilty for appointment.

Recaptcha *