Volunteer Sign Up Form

IIANC is organizing a voluntary network of member agents who would be willing to personally assist with claims and related duties in the offices of other IIANC members in areas impacted by hurricanes or other natural disasters this year. 

Before you complete this form, please discuss the matter with your staff and/or agency supervisor/principal and give serious consideration to what assistance you can realistically offer. Thank you for your willingness to help out fellow IIANC members!

Question Title

* 1. Yes, I would like to volunteer to assist IIANC member agencies.

Question Title

* 2. Name:

Question Title

* 3. Agency:

Question Title

* 4. Your City:

Question Title

* 5. Agency Phone Number:

Question Title

* 6. Cell Phone Number:

Question Title

* 7. Email Address:

Question Title

* 8. What Agency Management System does your agency use?

Question Title

* 9. What companies does your agency represent?

Question Title

* 10. Other information to share:

T