Master Agent Application Form
Thank you for choosing to join the Cognigen master agent program. Let's start by choosing your unique agent ID. This ID needs to be 2-12 characters long and it will be used to identify you as a Cognigen agent and help in the sales tracking process. It may also appear as part of your Cognigen web site URL addresses.
Note: Because your agent ID will appear on your Cognigen web site URL address, and will also display on some web pages, please make sure not to choose any sensitive information such as your SSN or the password from your bank account. We recomend your name or company name, or something simple and easy to remember. It is important to select the right agent ID, because this information cannot be changed after submitting the online application form!
NOTE: If you believe you cannot commit to $10,000 in billing customers, please consider joining our Free agent program
