Order Supplies through Savers. At Savers Marketing, our mission is to set our independent agents up for success which includes providing the supplies they need. You can request supplies by using the form below or by contacting our office. Please enable JavaScript in your browser to complete this form. Complete and submit this form to request supplies. Please only order supplies for one company at a time. Be as specific as possible in the materials you request (e.g. Application Kit-HHC 2015, Brochure-BR-v2, Medicare Complete Choice PPO/H2228 018). Name *FirstLastEmail *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCarrier Name *List One Carrier Per SubmissionProduct *MAPD, Final Expense, etc.Form State (and County/Region if Applicable) *Quantity Requested *Additional Comments or NotesSubmit