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Personal Cyber Express
Thank you for expressing interest in Emergence’s personalised Personal Cyber broker solution. Please complete the information below to enable us to set up your personalised webpage.
Broker Legal Entity Name
Broker Trading Name
Primary Brokerage Personal Cyber Contact
The primary brokerage personal cyber contact name above will be used by Emergence to liaise with your brokerage on any issues associated with the personalised Personal Cyber website. It will not be used for communications with clients.
Email for Personal Cyber Notifications
The email for personal cyber notifications will be used to copy your brokerage on all communications sent directly to the client e.g. issue of the policy document and renewal expiry notices. It will also be used to send you the monthly report of Personal Cyber policies bound during the last month through your brokerage.
Telephone Number for Personal Cyber
The telephone number will be displayed on the Personal Cyber generated emails and documents.
Broker Logo Upload
Max. file size: 50 MB.
.png format preferred but jpg acceptable
Broker Fee (excl GST)
Broker Cluster Group (if applicable)