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2017 Mid-Valley Claims Association

Membership Application
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YOUR MEMBERSHIP INCLUDES:
- Priority eligibility to purchase Golf Tournament tickets
- Discount Luncheon Price (with reservations)
- Invaluable continuing industry education, information, and networking
- A free subscription to the monthly Mid-Valley Claims Association News Network newsletter

Annual Membership Dues Renewed by Calendar Year.
Memberships are accepted from Insurance Company Claims Adjusters, Independent Adjusters, Insurance Defense Attorneys.
Associates members include industry service providers.
After the application has been received, All memberships are pending, subject to Board approval.

Individual
Just $25 per person
Corporate Membership
Just $100 - five (5) people or more
*Member Name & Company
*Member Email & Phone
*Contact Name, Co., Address, Ph & Email
*Primary Member Names (5)

To pay membership by check, please print this form
complete, and mail with your check payable to MVCA:

Mid-Valley Claims Association
P.O. Box 7634
Stockton, CA 95267

Contact/Mbr Name: ___________________________________

Company: __________________________________________

Mailing Address: ____________________________________

City, State, Zip: _______________________________________

Phone: _____________________ Fax: ____________________

Email: _______________________________________________

Address where you'd like to receive newsletter (if different):

___________________________________________________

Additional Corporate Member Names:____________________

____________________________________________________

____________________________________________________

_____________________________________________________


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