Greensboro Claims Association

MEMBERSHIP APPLICATION

(Please print or type)

 
Date: ______________________________________________________________________________

 
NEW______________________________________________________________________________

 
RENEWAL_________________________________________________________________________

 
CHANGES__________________________________________________________________________

 
Greensboro Claims Association

By—Laws

Article III, Membership, Section 1

The active membership of the Association shall be composed of individuals primarily engaged in claims related work.

Article VII, Committees, Section 1

Executive Committee: Within The limits prescribed in this Constititution and By-Laws, the executive power and responsibility for this Association shall be vested in the Executive Committee which will be comprised of the President, Vice-President, the Secretary, the Treasurer and the State Director. Any 2 officers plus the State Director must be licensed adjusters.
 
MEMBERSHIP DUES ATTACHED $ 20.00 annually

 

Please make checks payable to: Greensboro Claims Association

 

Return application with payment to :

Greensboro Claims Association

P. O. Box 4006

Greensboro, NC 27404
 
WELCOME TO GREENSBORO CLAIMS ASSOCIATION!
 
Name_________________________________________________________
 
Employer_______________________________________________________
 
Address________________________________________________________
 
E-Mail_________________________________________________________
 
Telephone________________________________Fax____________________
 
Job Title_______________________________________________
 
Job Description (Primary Function)_________________________________________________
 
Immediate Supervisor (New applicants only)__________________________________________
 
Length of Time Adjusting_________________________________________________________
 
Licenses Held__________________________________________________________________
 
Professional Designations (CPCU, AIC, etc.)___________________________________________
 
Willing to serve as Committee Member___________yes___________no
 
Home address_____________________________________________
 
Home Telephone___________________________________________