FAIA Volunteer Request

Full Name

Agency

Address

City

Zip

Fax

Years Experience in Insurance Industry

Interested in Serving On

InVEST Task Force Legislative and Regulatory Advocacy Council Pay It Forward Workforce Development Young Agents Task Force

*Members on these committees are appointed. If you are interested in serving on either of these committees please check the box to register your interest and a staff member will reach out to you.

Good Works Fund Committee Risk and Insurance Alliance

Please Confirm that you have Read Code of Ethics

Yes, I have read the Code of Ethics

Conflicts?

If you have read the FAIA Code of Ethics please indicate whether or not you have any conflicts (above)