The Church and Ministry insurance specialists!
Request for Certificate of Insurance
First Name
Last Name
Email Address
Phone
Fax No
Comments
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)