Membership Categories

Active:
The membership of the association shall be any person employed in the insurance related industries.

Active/Associate:
Membership may be granted to any member of the association provided that:

  • A member has become ineligible for active membership due to retirement:
  • A member in good standing at the time they became ineligible for active membership;
  • A member has held active membership for at least five (5) continuous years;
  • A member has held an elective office or appointed Board Chairman for at least three (3) years of membership:

All privileges of active membership would apply to this membership classification. The dues would be the same as set forth for an active member of the association.

Associate:
Any member who has been a member for one year or more and retires from the insurance business shall automatically become an Associate Member and be privileged to attend all meetings, but without a vote.

 

 

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* Indicates Required Field
*Renewal
New
*Have you attended 2 of past 4 regular meetings?
What 2 prior meetings did you attend?
Yes No
Your Membership Renewal Dues for June 1, 2011 to May 31, 2012 are as follows:
*Please Choose Applicable Membership:

*Note: New Active & Active Associate members joining after Jan 1, 2012, dues are $40.00 for the remainder of the fiscal year.

*Active Membership $50.00
Associate $25.00
*Active Associate $50.00
Please indicate above which membership you are paying.
Also, please complete the following information for the update of the membership list and yearbook.
*Name:
*Job Title:
*Job Function (Please check ONE which most closely applies):
CSR/Services
Adjuster
Underwriting
Producer
Claims
Clerical
Agency Owner
Accounting
Premium Finance
Risk Management
Marketing
Other
*Number of Years Employed in the Insurance Industry
0-5 6-10 11-15 16-20 21-25 30+
*Employer Name:
Employer Address:
City:
State:
Zip Code:
*Employer (Please check ONE which most closely applies):
Insurance Agency
Insurance Company
Premium Finance
Adjusting Firm
Managing GA
Trade Association
Retired
Other
Other:
*Type of Business (please check ALL that apply):
P/C
Life/Accident/Health
Finance
Other
Personal Information
*Home Address:
*City
*State:
*Zip:
Preferred Mailing Address:
Same as Above
City:
State:
Zip Code:
*Telephone # Business:
ext.
Telephone # Home:
*Email Address:
Professional Designations:
PIWT
ACSR
Dual ACSR
CISR
CIC
AAI
AU
Other: 
*Type of Insurance License You Currently Hold (please check ALL that apply):
Local Recording Agent
Insurance Service Rep
Group I
Group II
Risk Manager
Solicitor
Adjuster (type):
Not Applicable
Birthday:
Month/Year Joined IWSA:
Month: Year
DEADLINE FOR RENEWAL APPLICATIONS IS JULY 1, 2011, OR A LATE FEE of $10.00 MAY
BE ASSESSED. ANY MEMBER WHOSE RENEWAL DUES ARE NOT PAID PRIOR TO
OCTOBER 1ST OF EACH YEAR WILL BE REQUIRED TO MEET THE MEMBERSHIP
REQUIREMENTS OF SECTION 1G OF THE BY-LAWS.
*By initialing here you have agreed that the above information is true and accept membership rights of IWSA:
initials:
MEETINGS: 4TH THURSDAY OF EVERY MONTH EXCEPT JULY, NOVEMBER AND DECEMBER
Colors: Green and White Pin: Designed by James Avery
IWSA Committees you are interested in participating with (please check ALL that apply):
Entertainment
Name Tags
Scrapbook
Bulletin
Budget
Safety
Legislation
Convention
Publicity
Welcome
Fundraiser's
Yearbook
Bylaws
Other: