Add Association:

	About Clarion : Association Application

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Endorse Clarion
Association Name		Contact Person
Address
		City
Country Name		State Name
State Name (If country is not US or Canada)		Zip/Postal Code
Phone Number		Fax Number
EMail		Web Site URL
Number of Active members in the association
In what countries do the majority members reside?		On a percentage basis, how many members are under the age of 26? If you do not know, please estimate.	%
Annual membership fee	$	Is the purpose of the association strictly to purchase group insurance?	YesNo
Does the association currently have a musical instrument insurance program in place?	YesNo	If approved, will the association aggressively notify its members of this new insurance benefit?	YesNo
If approved, how would the association like the program to work?	Members would contact the association administrator to start coverage make changes. The association would pay the premium in full and collect from the individual member. The association would endorse Clarion and members will contact Clarion directly and the association will not have any involvement.