Insurance Questionnaire

Download Form as Word document
Download Form as PDF

The NFO is considering offering liability insurance to those members who are leaders of, or are connected with, dance groups or ensembles. In order to approach potential insurance companies for coverage, we need an estimate of those groups or ndividuals who would be interested in acquiring the coverage. The expected cost for the coverage (probably in the amount of $1 million in liability) is $50 or less per year.

Please answer the following questions:

Name  
Address  
   
Phone  
Phone #2  
Email  
Group associated with (if applicable)  
Group size (give a range)  
How often does the group meet (if applicable)  
For individuals, how large are the groups you teach (if applicable)  
Describe the nature of the group  
 
 

Please return the completed forms to: Mars Longden; 1402 Elinor Place; Evanston, IL 60201.
You can also fax the form to 847-328-5241 or scan and email it to SannaMars@aol.com.

Thanks for your help. If enough members are interested, we can launch the insurance for existing
members and then use it as a marketing tool to attract new members.

If you have any questions, please call me at 800-894-4378 or email me at SannaMars@aol.com.