Start Your Enrollment

Complete this form to start the enrollment process. After submission, the Primary Contact will receive access to the NIL Wealth Strategies Enrollment Portal via text or email to complete enrollment through Aflac's secure e-app. The e-app takes only a few minutes to complete, and underwriting is typically reviewed within 1–3 business days after submission.

Primary Contact Information

First Name *

Last Name *

Email *

Phone Number *

Coverage Selection

You may choose one coverage or both.

Coverage Type *

Total Covered: 1 person

Athlete Information(Optional)

0/1 max

No athletes added yet. Click + Add Athlete to add one.

Final Details

Your Role *

Who is coverage for? *

State *

How did you hear about us? *

Additional Notes (Optional)

I agree to receive text messages from NIL Wealth Strategies regarding my request for information and enrollment assistance. Message frequency varies. Message & data rates may apply. Reply STOP to opt out or HELP for help.

By submitting this form, you agree to our Privacy Policy and Terms. If you check the SMS consent box above, you may receive text messages from NIL Wealth Strategies regarding your request.