National Best

Contact Form Terms

Request for Service and Indemnification of NB Associate

I hereby request further information regarding the services and products which I have requested on the National Best on-line form. I consent to my personal information being disclosed to the appropriate representative(s) as required. This information will be held in accordance with the Personal Information Protection and Electronic Documents Act (PIPEDA). I acknowledge that the NB Associate who may receive an initial and/or ongoing commission or referral fee on the products and services listed.

I acknowledge that my NB Associate may not be licensed or qualified to discuss certain products. By sending this form, I indemnify the Referring NB Associate and National Best against any and all losses and/or damages associated with any/all products purchased through another licensed or unlicensed seller. I acknowledge and agree that the Referring NB Associate is not responsible for the proper placement of any referred product or its appropriateness. I will consult the duly-licensed seller as to the appropriateness of each product. Disclosures outlining any commissions, fees, and/or gifts received by my Referring NB Associate are available to me upon request. A complete listing of the NB Associate’s Outside Business Activities is also available upon my request. Note: Additional consent forms may be required at time of application.

 

I attest that the referrer without license has not held themselves out to be a licensed agent, nor have they described in any detail the products for which I have been referred.

Get In Touch

New Field

 

Head Office:
Unit#: 67B,  4511 Glenmore Trail SE,
Calgary, AB T3C 2R9

Phone: (403) 590-4500
Toll-Free: 1 800 503-6140
Fax: 1 877 904-7715