Request a Proposal Your Name*Your Role Within the Church*Church Name*Address* Street Address City State / Province / Region ZIP / Postal Code Denomination*Choose your denominationAlliance of BaptistsDisciples of ChristEvangelical Lutheran Church in AmericaPresbyterian Church (USA)Reformed Church in AmericaUnited Church of ChristOtherConferenceRegionPresbyterySynodOther Denomination*Insurance Board only serves churches within the four denominations listed above. We would be happy to forward your information to a local insurance agent who will be able to assist you.Email* Current Insurance CarrierCurrent Insurance Expiration Date MM slash DD slash YYYY Current Annual Insurance PremiumPhoneTell us about your church*How did you hear about Insurance Board*Colleague RecommendationReceived EmailReceived Postcard/Letter in US MailAttended a Meeting Where Insurance Board Presented or Displayed InformationGoogle SearchOtherCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
