Certificate of Insurance Request Form

Certificate of Insurance Request Form
This form is used to request a certificate of insurance for events and troop meeting places.

Please submit this form 1 week in advance of event or troop start date.
Requester Information:
Service Unit #:*
Troop #:*
Requester's Name:*
Email Address:*
example@example.com
Certificate of Insurance Information:
Certification Type*

Troop Meeting/EventCookie BoothOther
Year*

20242025
Name of Location (No Abbreviations):*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address:*
Street Address of Location
City:*
State:*
Zip Code:*
Comments:
Optional Specific Requirements Upload

Browse Files

Cancelof
Please allow 3 business days to be processed. You will receive an email with your certificate attached. If you have any further questions, please contact: info@gsnypenn.org or call us at 1.315.698.9400 or 1.800.943.4414.
Should be Empty: