Add Association:

• About Clarion : Association Application

  Please enter the following details and click the "Save" button to save your application.

• Please note fields that appear with * are mandatory. Endorse Clarion Association Name* Contact Person* Address*   City* Country Name* <--Select--> Outside US United States State Name* <-- Select --> Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Test State Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory 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?* Yes No Does the association currently have a musical instrument insurance program in place?* Yes No If approved, will the association aggressively notify its members of this new insurance benefit?* Yes No 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.