Membership

Become a Member

To apply for a new membership, please submit this form. You can pay online via card or PayPal.

Layout

Membership TypeFull MemberAssociate Member

Number of Personnel in AgencyUp to 5 ($100)6 - 10 ($125)11 - 20 ($175)20+ ($200)

Principals ARE considered employees of the agency. Include branch offices in the count.

Business Name *

Billing Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

• Check if the physical address is different than the billing address

Physical Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Website / URL

Primary Contact Name *

Primary Contact Email *

Primary Contact Phone *

Primary Contact Fax

List Coworkers that would like to receive notifications of events

Employee 1

Employee 2

Employee 3

Employee 4

Employee 5

Employee 1 Email

Employee 2 Email

Employee 3 Email

Employee 4 Email

Employee 5 Email

Note: Dues are based on the number of full time personnel and Principals are considered employees of the agency. Include all branch offices in the count.

Total

$ 0.00

Submit Application

Full Membership Renewal

Agency Name *

Your Name *

First

Last

Email *

Billing Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Number of Personnel in Agency5 or less - $1006 to 10 - $12511 to 20 - $175Over 20 - $200

Total

$ 0.00

Submit

Associate Membership Renewal

Company Name *

Your Name *

First

Last

Email *

Billing Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Associate Membership Renewal *

Price: $ 100.00

Total

$ 0.00

Submit

I would like to take this opportunity to thank all of you for your continued support of our organization. The Cape Cod Insurance Agents Association is only as strong as its members and through continued patronage, this allows us to continue to offer the education, events and resources to continue to function in the capacity necessary to strengthen our ever changing and challenging industry. From Agencies and Companies, Vendors,  we continue to learn so much from one another and I truly appreciate the efforts and willingness that each member and associate member provide.

To quote Navjot Singh Sidhu,

“You can’t play a symphony alone, it takes an orchestra to play it.”

Thank you all for being the orchestra!

With gratitude and deep appreciation,

Your Association President,

Helena M. Amorim