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!

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

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

Name:

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* 2. Name:

Agency:

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* 3. Agency:

Your City:

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* 4. Your City:

Agency Phone Number:

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* 5. Agency Phone Number:

Cell Phone Number:

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* 6. Cell Phone Number:

Email Address:

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* 7. Email Address:

What Agency Management System does your agency use?

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

What companies does your agency represent?

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* 9. What companies does your agency represent?

Other information to share:

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* 10. Other information to share:

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