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Effective URL: https://www.aia.com.ph/en/financialadvisor/join-us-now.html?reference=eyJjb2RlIjoiMDA3NjIxNzg3IiwibmFtZSI6IkkvTEFaQVJPL...
Submission: On June 08 via manual from US — Scanned from DE
Effective URL: https://www.aia.com.ph/en/financialadvisor/join-us-now.html?reference=eyJjb2RlIjoiMDA3NjIxNzg3IiwibmFtZSI6IkkvTEFaQVJPL...
Submission: On June 08 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<div class="tw-mb-10 tw-mx-10">
<h4 class="text-center tw-leading-none">Kickstart your entrepreneurial journey today</h4>
<p class="text-center bt3">Tell us more about yourself by filling out the form below</p>
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<p class="label">Honorifics</p>
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<option value="" disabled="disabled">Please Select</option>
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<div class="label tw-mb-2"><span class="tw-text-red required-asterisk">* </span>
<p class="label">First Name</p>
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<div class="label tw-mb-2"><span class="tw-text-red required-asterisk">* </span>
<p class="label">Last Name</p>
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<div class="validation-provider-wrapper tw-break-all" maxlength="20" placeholder="Please Insert" autocomplete="new-user-middleName"><label class="FormInputText tw-block">
<div class="label tw-mb-2"><!---->
<p class="label">Middle Name</p>
</div> <!----> <input type="text" maxlength="20" placeholder="Please Insert" autocomplete="new-user-middleName" class="!tw-w-full tw-block parent-width">
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<p class="label">Date of Birth</p>
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<div class="validation-provider-wrapper tw-break-all" placeholder="Please Insert" maxlength="50" required="required" autocomplete="new-user-email"><label class="FormInputText tw-block">
<div class="label tw-mb-2"><span class="tw-text-red required-asterisk">* </span>
<p class="label">Email Address</p>
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<p class="label">Mobile Number </p>
<section class="info-tooltip has-tooltip" data-original-title="null">
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<p class="label"> I'm Applying To Be </p>
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<div class="input-toggle-wrapper"><button type="button" value="true" id="BTN_true" class="btn-input-toggle tw-font-semibold tw-uppercase"> Full Time </button><button type="button" id="BTN_false"
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<p class="label">Preferred Location (City)</p>
</div> <!----> <!----> <select required="required" class="!tw-w-full tw-block primary-select parent-width">
<option value="" disabled="disabled">Please Select</option>
<option value="1"> Angeles </option>
<option value="2"> Antipolo </option>
<option value="3"> Antique </option>
<option value="4"> Bacolod </option>
<option value="5"> Bacoor </option>
<option value="6"> Baguio </option>
<option value="7"> Balanga </option>
<option value="8"> Baliuag </option>
<option value="9"> Batangas City </option>
<option value="10"> Binan </option>
<option value="11"> Bustos </option>
<option value="12"> Butuan </option>
<option value="13"> Cabanatuan </option>
<option value="14"> Cabuyao </option>
<option value="15"> Cagayan de Oro </option>
<option value="16"> Calamba </option>
<option value="17"> Caloocan </option>
<option value="18"> Candon </option>
<option value="19"> Cebu City </option>
<option value="20"> Cotabato </option>
<option value="21"> Dagupan </option>
<option value="22"> Dasmarinas </option>
<option value="23"> Davao </option>
<option value="24"> Dumaguete </option>
<option value="25"> General Santos </option>
<option value="26"> General Trias </option>
<option value="27"> Ilagan </option>
<option value="28"> Iligan </option>
<option value="29"> Iloilo </option>
<option value="30"> Imus </option>
<option value="31"> Kidapawan </option>
<option value="32"> Koronadal </option>
<option value="33"> Laoag </option>
<option value="34"> Lapu-Lapu </option>
<option value="35"> Las Pinas </option>
<option value="36"> Legaspi </option>
<option value="37"> Lipa </option>
<option value="38"> Lucena </option>
<option value="39"> Mabalacat </option>
<option value="40"> Makati </option>
<option value="41"> Malabon </option>
<option value="42"> Malolos </option>
<option value="43"> Mandaluyong </option>
<option value="44"> Mandaue </option>
<option value="45"> Manila </option>
<option value="46"> Marikina </option>
<option value="47"> Muntinlupa </option>
<option value="48"> Naga </option>
<option value="49"> Nasugbu </option>
<option value="50"> Navotas </option>
<option value="51"> Ozamis </option>
<option value="52"> Pagadian </option>
<option value="53"> Paranaque </option>
<option value="54"> Pasay </option>
<option value="55"> Pasig </option>
<option value="56"> Puerto Princesa </option>
<option value="57"> Quezon City </option>
<option value="58"> Roxas </option>
<option value="59"> San Fernando </option>
<option value="60"> San Jose del Monte </option>
<option value="61"> San Juan City </option>
<option value="62"> San Pablo </option>
<option value="63"> San Pedro </option>
<option value="64"> Santiago </option>
<option value="65"> Solano </option>
<option value="66"> Sta Rosa </option>
<option value="67"> Surigao </option>
<option value="68"> Tabuk </option>
<option value="69"> Tacloban </option>
<option value="70"> Tacurong </option>
<option value="71"> Tagbilaran </option>
<option value="72"> Taguig </option>
<option value="73"> Tagum </option>
<option value="74"> Tarlac </option>
<option value="75"> Tuguegarao </option>
<option value="76"> Valenzuela </option>
<option value="77"> Zamboanga </option>
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<p class="label">Introducer Name</p>
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<div class="label tw-mb-2">
<p class="label">I/LAZARO/ANA MAY/M@</p>
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<hr>
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<p>I confirm applying as a Financial Advisor for AIA Philippines Life and General Insurance Company, Inc. (Company), as contained in the form to which this Consent is attached.</p><br>
<p>I acknowledge and agree that, to maintain quality and provide efficient and effective evaluation of my application, the Company may require the facilities and/or assistance of third parties in processing my information.</p><br>
<p>In view thereof, I agree and authorize the Company to collect, record, organize, store for 10 years, update, modify, retrieve, consult, use, consolidate, block, erase, destroy, transfer and disclose any information (collected or held)
pertaining to myself, this application or my existing policies, if any, or any updates thereof under the following circumstances:</p><br>
<ol class="tw-ml-3 tw-list-decimal">
<li class="tw-pb-3">To conduct recruitment market research and/or leads campaign, promote marketing campaigns and/or activities, provide information covering products and/or services which the Company believes may be of interest to me,
and communicate with me for any purpose;</li>
<li class="tw-pb-3">To disclose my information to its affiliates and subsidiaries (including but not limited to any in the Asia Pacific Region), accredited or independent/non-affiliated third parties (whether local or foreign).</li>
</ol>
<p></p>
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</form>Text Content
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BE AN INSURANCE ENTREPRENEUR
Join AIA Philippines, and be in the business of helping more Filipinos Live
Healthier, Longer & Better Lives
KICKSTART YOUR ENTREPRENEURIAL JOURNEY TODAY
Tell us more about yourself by filling out the form below
*
Honorifics
Please Select
*
First Name
*
Last Name
Middle Name
*
Date of Birth
*
Email Address
*
Mobile Number
*
I'm Applying To Be
Full Time Part Time
*
Preferred Location (City)
Please Select Angeles Antipolo Antique Bacolod Bacoor Baguio Balanga Baliuag
Batangas City Binan Bustos Butuan Cabanatuan Cabuyao Cagayan de Oro Calamba
Caloocan Candon Cebu City Cotabato Dagupan Dasmarinas Davao Dumaguete General
Santos General Trias Ilagan Iligan Iloilo Imus Kidapawan Koronadal Laoag
Lapu-Lapu Las Pinas Legaspi Lipa Lucena Mabalacat Makati Malabon Malolos
Mandaluyong Mandaue Manila Marikina Muntinlupa Naga Nasugbu Navotas Ozamis
Pagadian Paranaque Pasay Pasig Puerto Princesa Quezon City Roxas San Fernando
San Jose del Monte San Juan City San Pablo San Pedro Santiago Solano Sta Rosa
Surigao Tabuk Tacloban Tacurong Tagbilaran Taguig Tagum Tarlac Tuguegarao
Valenzuela Zamboanga
Introducer Name
I/LAZARO/ANA MAY/M@
--------------------------------------------------------------------------------
I confirm applying as a Financial Advisor for AIA Philippines Life and General
Insurance Company, Inc. (Company), as contained in the form to which this
Consent is attached.
I acknowledge and agree that, to maintain quality and provide efficient and
effective evaluation of my application, the Company may require the facilities
and/or assistance of third parties in processing my information.
In view thereof, I agree and authorize the Company to collect, record, organize,
store for 10 years, update, modify, retrieve, consult, use, consolidate, block,
erase, destroy, transfer and disclose any information (collected or held)
pertaining to myself, this application or my existing policies, if any, or any
updates thereof under the following circumstances:
1. To conduct recruitment market research and/or leads campaign, promote
marketing campaigns and/or activities, provide information covering products
and/or services which the Company believes may be of interest to me, and
communicate with me for any purpose;
2. To disclose my information to its affiliates and subsidiaries (including but
not limited to any in the Asia Pacific Region), accredited or
independent/non-affiliated third parties (whether local or foreign).
Submit
--------------------------------------------------------------------------------
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