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.
 Express Service Phone (800) 728-5413 or fax to (407) 834-1525 
                     Policyholder Name                                      Beneficiary Name

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.