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People & Places Submission Form

Does Someone In Your Agency Deserve Recognition?

It's easier than ever to publicize your people in Insurance Journal. No need to send a press release, just fill out this form completely and push the "submit" button or print out and fax it to (619) 584-1200.

If you would like to submit pictures, send an e-mail attachment (jpg format) to asimpson@insurancejournal.com giving names of the people in the pictures.

Company Information:
* Company Name:
Address:
* City:
* State:
* Email:
Website:

Recognized Person Information:
* Name of Person:
* Person's Email:
* Current Job Responsibilities
* New Title:
Reason for recognition (please check box and fill in blank):
Promotion * Former Title:
New Hire * Former Title and Company:
 Elected Position * Position title:

* Former Job Responsibilites
Award Name of Award/Association:
Retirement Years of Industry Service:
Other Explain:
Additional Information:
* Contact Name:
* Email:
* Title:
* Phone :