2024-2025 IWSA Membership Form
IWSA is a professional organization of women and men in the insurance industry and related support companies. Formed in March 1944, our purpose is to promote education for members, provide scholarships to area students, and contribute to the community through charitable service. We are one of 10 local associations included in the Federation of Insurance Women of Texas Inc. (FIWT)
Application Type
*
New Membership
Renewal Application
Membership Type
*
Active - $75.00
Active Associate - $75.00
Associate - Dual Membership - $25.00
Name
*
First Name
Last Name
How did you hear about IWSA?/ Who were you referred by?
Birthday
*
-
Month
-
Day
Year
Date
Preferred Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Job Function
*
Please Select
CSR
Producer
Agency Owner
Risk Management
Clerical
Claims
Adjuster
Accounting
Marketing
Underwriting
Premium Finance
Other
Number of Years in Insurance Industry
Please Select
0-5 years
6-10 years
11-15 years
16-20 years
20+ years
Professional Designation - Please mark all that apply
PIWT
ACSR
Dual ACSR
CISR
CIC
AIA
AU
CPCU
CIPT
ARM
Other
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Employer Information
Employer
*
Work Phone Number
Please enter a valid phone number.
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Job Title
Employer Type
*
Please Select
Insurance Agency
Adjusting Firm
Trade Association
Insurance Company
Managing GA
Premium Finance
Retired
Other
Types of Business (Mark all that apply)
*
Property/Casualty
Life/Health/Accident
Finance
Other
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Month/Year You First Joined IWSA:
*
Are you a member of another Local Organization under FIWT?
*
Yes
No
If yes, which local organizations?
Which local is designated your main local?
Are you an under 40 member?
*
Yes
No
What committees would you be interested on serving on? (Mark all that apply)
Community Service
Welcome
Scrapbook
Fundraiser
Website/Social Media
Name Tags
By-Laws
Yearbook
Budget/Audit
Convention
Entertainment
Golf
Other
My Products - please note that there is a $3 online processing fee included
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( X )
Active Member
$
78.00
Active Associate Member
$
78.00
Associate Member
$
28.00
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