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Affiliation statement application form

Thanks for your interest in using the Canada Life affiliation statement.

Note: When we reference being “self-branded”, we mean you are no longer using the Freedom 55 Financial brand in any way and you are holding out under your own brand (e.g., Smith Financial), either a firm or a sole proprietor.

If you have questions about Canada Life affiliation, please contact your field leader.

All fields are required.

Depending on your choices, some fields could be added to this form.

You will receive a confirmation email upon submission of this form.

I confirm that:

You must be able to accurately check each box.

Being “self-branded” includes having your own brand as a sole proprietor or being incorporated, or being part of a firm that has it’s own brand.

Acknowledgement