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QUESTION #1
PRIMARY BUSINESS CATEGORY
Agents, Brokers, & life General Agents
__ 01 Primarily Selling Property/Casualty Insurance
__ 02 Primarily Selling Life/Health Insurance
__ 03 Life General Agents & Managers
Insurance Company Personnel
A. Primary Life Insurance
__ 04 Home Office Personnel
__ 05 Regional & Branch Office Personnel
B. Primarily Property/Casualty Insurance
__ 06 Home Office Personnel
__ 07 Regional & Branch Office Personnel
Corporate Risk Managers & Buyers of Insurance
__ 08 Property/Casualty Insurance
__ 09 Employee Benefits Plans
__ 10 Both: P&C And Employee Benefits
__ 11 Other ____________________
QUESTION #2
YOUR TITLE

__ AA. Corporate & Financial Mgmt
Chairman, CEO, President, Partners
Owner, VP, Treasurer, Secretary
Controller, or Budget Director
__ BB. Supervisory Management
Manager, Supervisor, Department Head
__ CC. Marketing/Sales
Director of Marketing/Advertising Agent,
Producer, Broker
__ DD. Other ___________________


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