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BQP Details
Intermediary Type
*
Select Intermediary Type
Insurance Brokers
Applicant Type
*
Select Applicant Type
Fresh
Renewal
Educational Qualifications
*
Bachelors degree in Arts, Science, or Social Sciences or Commerce or its equivalent from any institution/ university recognized by any State Government or the Central Government
Bachelor's degree in engineering or its equivalent from any institution/university recognized by any State government or the Central Government
Bachelor's degree in law or its equivalent from any institution or university recognized by any State Government or the Central Government
Masters in Business Administration or its equivalent from any institution/ university recognized by any State Government or the Central Government
Associate/ Fellow of the Insurance Institute of India, Mumbai
Associate/Fellow of the Institute of Risk Management, Mumbai
Post graduate qualification of the Institute of Insurance and Risk Management, Hyderabad
Associate/ Fellow of the Institute of Chartered Accountants of India, New Delhi
Associate/ Fellow of the Institute of Cost and Works Accountants of India, Kolkata
Associate/ Fellow of the Institute of Company Secretaries of India, New Delhi
Associate/ Fellow of the Institute of Actuaries of India
Associate/Fellow of Chartered Insurance Institute, London
Chartered Financial Analyst of Institute of Chartered Financial Analyst of India
Certified Associate ship of the Indian Institute of Bankers, Mumbai
Any other qualification specified from time to time by the Authority under these regulations
Corporate Type
*
Select Corporate Type
Principal Officer
Broker Qualified Person
Insurance Category
*
Select Insurance Category
Direct Life and General
Personal Information
Salutation
*
Select Salutation
Ms.
Mrs.
Mr.
Applicant Name
*
PAN No
*
Qualification Details
Basic Qualification
*
Select Basic Qualification
Graduation
Post Graduation
Date of Birth
*
Gender
*
Select Gender
Male
Female
Area
*
Select Area
Urban
Rural
Contact Information
House No
*
Street
*
Town / City
*
State
*
District Name
*
Pin Code
*
Mobile Number
*
Email
*
Alternate Email
*
Applicant Photo and Signature
Applicant Photo
*
Upload JPG only (.jpg, .jpeg), max 25 KB, 133x152 px
Applicant Signature
*
Upload JPG only (.jpg, .jpeg), max 25 KB, 133x152 px
Submit
