Activate Your MIA Account

No cost. No commitment. You own your book from day one.

First Name *

Last Name *

Email *

Mobile Phone Number *

📱 This must be a mobile number — it's used for portal login and account verification. You can update your marketing number later in the portal.

Agent Type *

Licensed States *

Select all states where you hold an active P&C license.

How do you plan to refer clients? (select all that apply)

How did you hear about MIA?

Agreement & Terms

I have read and agree to the MIA Participation Agreement and the Terms & Conditions. *I confirm that I am not currently bound by any captive or exclusive carrier agreement that would restrict my participation in a referral platform. *I consent to receiving SMS and email communications from MIA regarding my account, commissions, referral activity, and platform updates. Message & data rates may apply. Reply STOP to opt out of SMS at any time. *

No credit card. No commitment. You own your book from day one.