Asteron Life - Apply Now for AdviserConnect

Apply Now for AdviserConnect

We welcome your application for access to AdviserConnect^TM, Proposal Tracking and Policy Information. By completing this form and submitting it to us, you will gain access to AdviserConnect^TM with materials and information to make doing business with us and working with clients easier.

In addition to the purposes stated in the Privacy Policy, we may contact you from time to time to ensure you are receiving the level of service you require from Asteron Life Limited and that AdviserConnect^TM meets your requirements. If you do not want to be contacted, please advise us by calling AdviserConnect Support 1800 151 488 or email adviserconnect_support@asteron.com.au.

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Adviser Details

Broker/Agent Number(s):*
First Name:*
Surname:*
Business Name:*

Assistant Details

I authorise the following to access AdviserConnect^TM, Proposal Tracking and Policy Information referrable to the Broker/Agent Number specified on my behalf.

First Name:*
Surname:*
Contact Number:*
Security Question:*	(eg What is my mother's maiden name?)
Answer:*
The security question and answer are required for security and privacy reasons. You will be asked to answer this question when making enquires, to ensure the privacy of the client's details is upheld.
Email:*

Declaration

I understand and accept that, by submitting this form, I agree to the following:

I have read and agree to be bound by the Terms of Use and Privacy Policy as they apply to AdviserConnect^TM including any updates and/or amendments to such Terms of Use and Privacy Policy as notified to me by Asteron Life from time to time.
I warrant that the assistant nominated in this application form has been provided with a copy of the Terms of Use and Privacy Policy and will comply with the Terms of Use and Privacy Policy (including any updates and/or amendments to such Terms of Use and Privacy Policy by Asteron Life which I must notify to the assistant from time to time).
I agree to promptly advise Asteron Life of any changes in details or circumstances that will affect the provision to me of AdviserConnect^TM and Policy Information.
I understand that I may at any time notify Asteron Life that I no longer wish to receive marketing information from Asteron Life. However, I recognise that if I do so that this may affect the services that will be provided to me.
I understand that I, and any of the assistant(s) I have authorised to be given access, can only access Proposal Tracking and Policy Information in respect of:
(a) Agent Number(s) when a current agency agreement exists with Asteron; or
(b) Broker Numbers while the broker is registered as a life insurance broker, and subject to any contrary direction from the policyowner.