Please complete the following questions for membership in the Greater Cincinnati Insurance Board.
 

Contacts Persons Name:  _______________________________________________________________

Company Name: ______________________________________________________________________

Street Address: _______________________________________________________________________

P.O. Box:   __________________________________________________________________________

City: ____________________________________________ State: _____________   Z ipcode: ____________________

Phone: ________________________________ Fax: ____________________ ___________________

Internet Address: ____________________________________________________________________

E-mail Address: ____________________________________________________________________
 

Annual Company Membership Dues:                                                                     $500.00
 

Make check payable to the Cincinnati Insurance Board and
send it to :  The Greater Cincinnati Insurance Board
                  5535 Fair Lane, Suite A
                  Cincinnati, Ohio 45227