Membership Application

Before completing the application below, please review our Membership Policies & Dues page for descriptions of our Individual, Retired Individual, Academic Individual, and Academic Group memberships, and our policy concerning Corporate memberships and subsidiaries or branch locations. If after reviewing that information you have any questions, please contact our Executive Director by email to mpezza@insurancelibrary.org.

When completing the application, please provide all requested information and state the Member Name exactly as it should appear in our records. After we review your application, we will send you a dues invoice. Your membership is effective upon our receipt of payment.

We appreciate your interest in the Library and welcome your membership and involvement in our programs and events.

"*" indicates required fields

Member Name*

If your organization has more than one location and you are applying for a corporate membership for just one location, please state that location in the member name.

Membership Type & Level*

Primary Contact Name*

Prefix First Last

Email*

Phone*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Organization Website (if applicable)

Questions or Comments

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