NAIC Consumer Representative Application

NOTE: Please complete this application if you did not serve as an NAIC Consumer Representative in 2026.

If this does not apply to you please return to the NAIC Consumer Participation Program webpage and use the application for a Returning Consumer Representative.

In addition to completing this application, at the end of the application you must also:

• Sign the Conflict of Interest statement.
• Upload a resume or CV (other pertinent information, such as organization publications, testimony, references, or letters of recommendation are useful but optional).
• If you represent an organization, upload a copy of the organization’s budget.

Any question with an asterisk requires a response.

Please provide a response to every question. If a question does not apply enter "N/A."

To go back to a previous page, click the "Previous" button at the bottom of the page.

You do not need to complete the application in one session. If you return to the application on the same device you will see your previous work.

To save your progress on a page you must click "Next" at the bottom of the page.

Please note that after you submit your application, you will not be able to make any further changes.