The UFO Abduction Insurance
Co.
Honorary Agent Application
Thank you for your interest in our Honorary Agent Program.
I agree as an Honorary Agent of the UFO Abduction Insurance Co.
I will offer
this Policy only to those who have a Sense Of Humor .
Please complete the following application.
Name_____________________________________________________________________
Address___________________________________________________________________
City______________________________State____________Zip/PostalCode____________
Country__________________________E-Mail Address____________________________
Phone______________________________ Fax___________________________________
Signature___________________________________________________________________
Initial 10 Policies & future policies to be billed
through The Saint Lawrence Agency
to Amex/Mastercard/Visa
Name on Card______________________________________________________________
Type of Card____________Card #______________________________________________
Exp. Date______________ Signature____________________________________________
Agency Single Lifetime Premium - $9.95 + $3.00 Same Day U.S.
Shipping.
Policy #1 ____________________________
_________________________________
Policy #2 ____________________________
_________________________________
Policy #3 ____________________________
_________________________________
Policy #4 ____________________________
_________________________________
Policy #5 ____________________________
_________________________________
Policy #6 ____________________________
_________________________________
Policy #7 ____________________________
_________________________________
Policy #8 ____________________________
_________________________________
Policy #9 ____________________________
_________________________________
Policy #10 ____________________________
_________________________________
"Beam Them Up, They're Covered"
Please send or fax the Honorary Agent application
to:
The Saint Lawrence Agency
319 Hermit's Trail
Altamonte Springs, Florida 32701
(407) 260-5433
Your Initial 10 Policies will be sent to your
application address.
You will be issued an Agency Number and Subsequent
policies will be shipped to the shipping address indicated at our secure
online ordering site.
Your Agency # which will enable you to purchase
additional Gold Bordered Policies for $9.95 plus $3.00
Shipping.
We can only hope that soon you will join the
Billion Dollar Round Table
and be the proud owner of your own
Pink UFO.
Thanks again for your interest.
If you should have any additional questions please
give me a call
Mike St. Lawrence - President & CCBW
The UFO Abduction Insurance Co.
(407) 260-5433
Now back
to The UFO Abduction Insurance Co.