Blink IS

Application Form

Welcome



To link to blink, please complete the online form if you wish to apply for a Blink Intermediary Solutions agency, which will provide access to a range of insurance products and associated business services.

The process bar above will guide you through the application and should not take more than 5-10 minutes to fully complete.

Alternatively complete up to stage 3 ' Branches / Directors' and click on 'Save and Complete'. One of our sales team will then make contact and complete the rest of the application form with you.

The fields in Blue Bold are mandatory.

Personal Data





 Tick to agree to the use of your personal data in the manner set out above.



Marketing Information



We may use, analyse and assess information held about you, including the nature of your transactions to give you information about products and services from members of the Iris Group, which we think may interest you by phone, post, or other means. We may pass this information to other members of the Iris Group so that they may do the same.

 Untick if you do not wish to be contacted in this way.

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