Become An Agent

Agency appointment application

Become a Falcon Agent

Please fill out the form below and you will be contacted soon thereafter regarding becoming an agent for Falcon Insurance. Any questions about becoming an Agent? Please contact us at

Tell Us Who You Are

NOTE: If You Use A Social Security Number For The Business ID Number, The Agency Name Must Be The Full Name Of The Person Belonging To That Social Security Number.

Carriers You Represent

Top Auto Carrier 1

Top Auto Carrier 2

Top Auto Carrier 3

What Do You Use?

Other Questions

I hereby certify under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge and belief. I also hereby agree to the disclosure and release of any information pertinent to this application held by any person or any educational, law enforcement, governmental or business entity.