CORPORATE MEMBERSHIP APPLICATION JACKSONVILLE CLAIMS ASSOCIATION


P.O. BOX 17311, Jacksonville, FL 32245-7311 | www.jaxclaims.com


Before checking a type of membership, read the description of membership types below. Check only one.


q New Corporate Regular Member q New Corporate Sponsor Member


q Renewal Corporate Regular Member q Renewal Corporate Sponsor Member


Membership Types Corporate Regular Members are those firms whose associates possess a current State Adjuster’s License and/or are directly engaged in claims handling. Claims handling is defined to mean spending the majority of time in the investigation, negotiation, and settlement of insurance claims, or supervising or managing persons so engaged, attorneys whose principal practice is insurance defense, appraisers and surveyors whose major duties are devoted to insurance claims or are retired members in good standing. All other companies who are providing services or products to the claims profession are classified as Corporate Sponsor Members.


Dues Corporate Regular Membership and Corporate Sponsor Memberships can be used by companies who have more than five individual members. Corporate Regular Membership is $150.00 and Corporate Sponsor Membership is $300.00. Corporate membership covers all members of the firm at no extra charge after the first five have been named in the application. Those designated will receive meeting notices and are the only members of the organization that have voting privileges at any official meeting/function. Corporate Regular Membership Applications and Corporate Sponsor Membership Applications are also available on-line or upon request to the Membership Chairperson.


Application/Acceptance We hereby make Corporate Application to the Jacksonville Claims Association. If our Corporate Application is accepted we and our members agree to adhere to the Antitrust Policy and abide by the Constitution and By-Laws adopted by the Jacksonville Claims Association. Please make check payable to Jacksonville Claims Association or if you prefer, you can complete an application on-line and pay by credit card on-line.


Check One: q Corporate Regular Membership q Corporate Sponsor Membership


Corporate Representative Name:__________________________________ Position: __________________________________ Firm Name: ________________________________________________________________________ Mailing Address: __________________________________________________________________ City:_______________________________________ St: ___________ Zip: _____________________ Telephone: _______________________________________ Fax: _____________________________ Email: _____________________________________________________________________________


Apply Online at www.jaxclaims.com OR Please forward application and payment to: Membership Committee


JACKSONVILLE CLAIMS ASSOCIATION P.O. Box 17311, Jacksonville, FL 32245-7311 140 2012 Jacksonville Claims Association Resource Guide


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