NORTH CAROLINA ADJUSTERS ASSOCIATION
MEMBERSHIP APPLICATION
__New Member ___
Renewal ___ Changes
Date:____/____/____
NCAA By-Laws
Article III - Membership
Section 1. Member: Any person upon application and
payment of dues, provided the person is:
(1) A resident of the State of North Carolina or a
resident of any State adjoining North Carolina, whose place of
employment and primary work performance is within the State of North Carolina.
(2) Activity engaged in, or retired from the handling
of claims as an appraiser, adjuster, claims examiner, claims
supervisor, claims manager, or by any other title as long as the
primary function of such person is within the scope of duties
performed by the aforestated classification.
(3) Employed by an insurance company, a self-insured
entity, or has been fully licensed by the State of North Carolina as
an independent appraiser to service claims for insurance companies
for self-insured entities.
NAME:______________________________________________________________
EMPLOYER: _________________________________________________________
ADDRESS:___________________________________________________________
TELEPHONE:_________________________________________________________
JOB TITLE:___________________________________________________________
BRIEF JOB DESCRIPTION:_____________________________________________
(Primary Function)
____________________________________________________________________
IMMEDIATE SUPERVISOR: ____________________________________________
(new applications only)
LENGTH OF TIME IN ADJUSTING:______________________________________
LICENSE(S) HELD:____________________________________________________
PROFESSIONAL DESIGNATIONS (CPCU, AIC, Etc.:________________________
MEMBER OF LOCAL CLAIMS ASSOCIATION: ___YES ___NO
NAME OF ASSOCIATION:______________________________________________
WILLING TO SERVE AS COMMITTEE MEMBER:___________________________
HOME ADDRESS:_____________________________________________________
HOME TELEPHONE:__________________________________________________
ASSOCIATION --------------ADUSTERS DUES------------------VENDORS DUES
__Alamance-------------------------$10.00------------------------------$10.00
__Western Carolina(formerly Asheville) -$10.00------------------------------$25.00
__Charlotte--------------------------$15.00------------------------------$15.00
__Fayetteville------------------------$15.00------------------------------$15.00
__Greensboro-----------------------$20.00------------------------------$20.00
__Greensville------------------------$15.00------------------------------$15.00
__Neuse-----------------------------$8.00-------------------------------$8.00
__Northwest-------------------------$8.00-------------------------------$8.00
__Raleigh----------------------------$10.00------------------------------$10.00
__Rocky Mount---------------------$15.00------------------------------$15.00
__Tri-City---------------------------$10.00------------------------------$10.00
__Wilmington------------------------$25.00------------------------------$25.00
State membership included with local dues.
Total: $_________________
Mail To:
Mike Allen - United Appraisal Network
NCAA President
P.O. Box 15573
Wilmington, NC 28412
any questions call
1-800-530-1431
mallen@unitedappraisalnetwork.com
GET INVOLVED TODAY!