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Website Design & Hosting
Social Media Management
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Content Development and Management
About Us
Press & News
Member login
Contact Us
Cloudbridge Premium Content & Design Form
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Cloudbridge Interest Form
Cloudbridge Premium Content & Design Form
Step 1 of 2
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General Company Information
Company Name
*
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Company Phone Number
*
Company Fax Number
Current General Contact Email
*
Hours of Operation
*
Monday: 8:00am - 5:00pm Tuesday: 8:00am - 5:00pm Wednesday: 8:00am - 5:00pm Thursday: 8:00am - 5:00pm Friday: 8:00am - 5:00pm
Company Logo
Upload Company Logo
Domain Name Information
Looking for that perfect domain name? See if it's available at: https://instantdomainsearch.com/
Do you own your domain name or do you need us to purchase it?
*
I own my own domain
I need Cloudbridge to purchase my domain name for me
What is Your Domain Name?
*
What is Your Desired Domain Name?
*
Website Content
If no text is provided, we will utilize default text provided by the SIAA Marketing Department.
Preview
Default Cloudbridge Text
here.
Please choose if you would like default content or custom content for each section.
*
Yes, I would like to use all Default Content
Custom Content - About Us Page
Custom Content - Overview Page
Custom Content - Benefits Page
Custom Content - The Vision
Custom Content - Mission
Custom Content - Overview Page
*
Custom Content - Benefits Page
*
Custom Content - The Vision Page
*
Custom Content - Mission Section
*
Custom Content - About Us
Meet Our Team Page
Will You Be Providing Agent Bio's and Photos for Your Website?
*
Yes
No
Agent Biographies
Please upload all of your Agent's Biographies and photos in a single Word Document. We will format the text and match it with each agents' photo and contact information.
Agent's Biographies
*
For each agent, please include: Photo, Name, Phone Number, E-Mail, Biography
Contact Us Page Information
Email for all "Contact Us" Requests to be Submitted
Our Partners Section
Strategic Partners
Please choose who your strategic partners are.
*
Allied
Allstate
American Modern
AmTrust
Dairyland Auto & Cycle
Encompass
Foremost
Grange Mutual
Guard
Hagerty
Hanover
The Hartford
Liberty Mutual
Main Street America
Mapfe Insurance
Merchants
MetLife
National General Insurance
Safeco Insurance
State Auto
Titan Insurance
Travelers
Other
Other Strategic Partners
*
Click the + to add more.
Non-Strategic Partners
Please choose who your non-strategic partners are.
*
Allied
Allstate
American Modern
AmTrust
Dairyland Auto & Cycle
Encompass
Foremost
Grange Mutual
Guard
Hagerty
Hanover
The Hartford
Liberty Mutual
Main Street America
Mapfe Insurance
Merchants
MetLife
National General Insurance
Safeco Insurance
State Auto
Titan Insurance
Travelers
Other
Other Non-Strategic Partners
*
Click the + to add more.
Program Partners
Please choose who your program partners are.
*
Allied
Allstate
American Modern
AmTrust
Dairyland Auto & Cycle
Encompass
Foremost
Grange Mutual
Guard
Hagerty
Hanover
The Hartford
Liberty Mutual
Main Street America
Mapfe Insurance
Merchants
MetLife
National General Insurance
Safeco Insurance
State Auto
Titan Insurance
Travelers
Other
Other Program Partners
*
Click the + to add more.
Vendor Partners
Please list your Vendor Partners
*
Click the + to add more.
Premium Finance Partners
Please list your Premium Finance Partners
*
Click the + to add more.
Social Media Links
Please provide us with your social media URL's so we can add these to your website!
Social Media Platform
Twitter
Facebook
LinkedIn
Xing
Renren
Google+
Disqus
LinkedIn Pulse
Snapchat
Tumblr
Pinterest
Twoo
MyMFB
YouTube
Instagram
Vine
WhatsApp
vk.com
Meetup
Secret
Medium
Social Media Link
Untitled
Privacy Policy
A Privacy Policy is required for your website. SIAA provides a default that you can read below, or if you choose, you may provide your own. Click the link below to view our Privacy Policy:
Cloudbridge Privacy Policy
Privacy Policy (Please select one)
*
I consent to adding the default SIAA Privacy Policy linked above
I have my own Privacy Policy
Website Service Agreement
By clicking the checkbox below you are agreeing to the
Website Services Agreement
between your company an Cloudbridge Solutions.
I agree with the website services agreement as described in the above link.
*
I AGREE WITH THE WEBSITE SERVICES AGREEMENT
ACH Payment Form
By checking this box you agree that you must fill out the ACH Payment Agreement and send it back to "Forms@CloudbridgeSolutions.com" before my website will enter the development queue.
ACH Payment Form
I understand I must send in the above ACH Form prior to my website entering the development queue.
*
I UNDERSTAND I MUST FILL OUT THE ACH FORM TO COMPLETE REGISTRATION
