I.I.I. Membership Applications

Associate Application

Associate, Regulator & Academia applicants fill out this application.

Or, if you would like to speak with our Membership Director, Deena Snell, please call 212-346-5550.

First Name*
Last Name*
Title*
Company Name*
Company Website*
Briefly describe your company's connection to the insurance industry (broker/agent, consultant, vendor, etc.)*
Work Email*

No personal email addresses.
Phone*
Address*
Street Address City State ZIP Code
I affirm that neither I nor my company work with or support plaintiff litigation or third-party litigation funding.*

Our team is standing by to help.