MembershipName of company*Professional InformationCompany Postal Address*Office location(s)*Business phone*Business fax*Brokers license year*How many years has this company held its brokers license?Upload certificate*Accepted file types: jpg, jpg, jpeg, jpeg, png, png, pdf, pdf, Max. file size: 10 MB.Please Attach a Certificate of Good Standing from the The Insurance Commission of the Bahamas. Accepted formats: jpg, png and pdf files of no more than 10MB size.Appointed primary representative*Job title*Qualifications held*Secondary representativeJob titleQualifications heldMembership InterestAs a member of BIBA, on which committee would you like to be actively involved?* Education Public Relations Membership Legislation OtherI hereby agree to abide by the Code of Practice of The Bahamas Insurance Brokers Association and will do all that I can to uphold the respect and dignity of the Brokers Profession.* I agree