Smarter Cyber for trailblazing brokersbroker registrationTo register for the Emergence Broker Portal, please submit the contact form below. Our friendly team will create your profile and send you all relevant onboarding information. Register now Let's get startedregister nowPlease submit the form to request your portal registration. Our team will be in touch with your login information and onboarding resources."*" indicates required fieldsBroker registrationBroker website* Broker legal entity name*Broker trading name*Brokerage branch*Primary Brokerage contactThe primary brokerage contact will be used by Emergence to liaise with your brokerage. It will not be used for communications with clients.First Name*Last Name*Phone*Email* Brokerage contactsEmail for notices* This is the email address that will be used to send Renewal notices and Claims notices. Notices should not be linked to an individual broker. We recommend a Group email such as 'info@...'.Email for finance/premium payments* This is the email address that will be used for notification of finance/premium payments. Notices should not be linked to an individual broker. We recommend a Group email such as 'finance@...'.Address Street address Suburb State Post code Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country LicensingLicensing* AFSL holder Authorised representativeAFSL number*Authorised representative number*Cluster Group*Cluster GroupAustbrokersSteadfastNon-Aligned / IndependentOtherCluster group / other*Broker Group (if applicable)*Broker Group (if applicable)Apollo Risk ServicesAusureAustralian Broker Network (ABN)AvisoAviso SelectBrindabella Insurance Brokers (BIB)Community Broker Network (CBN)Insurance Advisernet Australia (IAA)Insurance Brokers Australia (IBA)International Insurance Brokers (IIB)Insurance House (IH)Marsh AdvantageMcLardy McShaneMcCormick Harris & AssociatesNetwork Insurance GroupNutrien AG SolutionsOracle GroupPSC ConnectPSC InsurancePSC Reliance PartnersResiliumUnited Insurance GroupWestcourt General Insurance BrokersOtherCluster group / other*Personal Cyber ExpressDo you want to enable Personal Cyber Express for your Brokerage?* Yes, enable Personal Cyber Express for my Brokerage No, don't enable Personal Cyber Express for my BrokerageEmail 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.Broker fee (ex GST)*Telephone number for Personal Cyber*The telephone number will be displayed on the Personal Cyber generated emails and documents.Broker logo* Drop files here or Select filesAccepted file types: jpg, png, Max. file size: 3 MB, Max. files: 1.Terms and conditionsI have read and agree to the Terms and Conditions of Trade* I have read and agree to the Terms and Conditions of TradePhoneThis field is for validation purposes and should be left unchanged.Δ
