If you would prefer to fill out a paper application and submit it by mail, please print the PDF provided below. You may need Adobe® Acrobat® Reader® to view the file.
Please use the information below to complete the advisor fields. That way we’ll know who sent you to us.
ADVISOR CODE: N7165
OFFICE CODE: HA370
MGA CODE: 9003
ADVISOR NAME: Diana Tuszynski
OFFICE NAME: Canadian Benefits Associates Inc.
MGA NAME: Canadian Benefits Associates Inc.