The Church and Ministry insurance specialists!
Request for Certificate of Insurance
First Name
Last Name
Email Address
Fax No
Ministry Name
Certificate is for
Date of Event
Contact Name
Contact #/Email
(Name of your ministry)
(Name of the other organization)
Please include a basic description of the event for which the certificate is needed and any other necessary details.
(Please indicate the email, fax # or address we should send to)