Request a Proposal 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 ChristOtherConference Region Presbytery Synod Other 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 Carrier Current Insurance Expiration Date MM slash DD slash YYYY Current Annual Insurance Premium PhoneTell 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 SearchOtherCAPTCHANameThis field is for validation purposes and should be left unchanged.