New Partner Registration | Lavalier Jewelry Insurance

Complete the following form to register for the Lavalier Partner Jewelry Program. We will contact you about next steps.

If you have already received a Lavalier Jeweler Agreement, email the signed agreement to marketing@lavalier.com. If you have any questions, please call us at 855-477-6687.

Learn more about how Lavalier works. Watch the video.

Store Details

Store Name

First Name

Last Name

Email Address

Street Address

Address Line 2

City

State

Zip Code

Store Website

Store Phone

Attach Marketing Materials or Graphics

Accepted file types: ai, eps, png, jpg, pdf, zip.

Please attach any agreements, partner provided documents or images to be used for page design. Vector graphics are preferred for logo files. Accepted file types: .AI, .EPS, .JPG, .PNG, .PDF, .ZIP

Agency Details

How did you hear about Lavalier?

Agency Name

First Name

Last Name

Refer A Friend