Request for a Certificate of Insurance

Request for Certificate of Insurance

Use this form if a business or organization is requesting a certificate of insurance for your Unit’s meeting or event. Certificates are sent directly to the outside organization who needs the certificate on file. If you need a certificate above the standard $1 million limit, you must contact the Scout Center directly.

About You

Your Name(Required)

First Last

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Position/Title(Required)

Committee Chair

Committee Member

Scoutmaster (or Assistant)

Cubmaster (or Assistant)

Venturing Advisor (or Assistant)

Exploring Advisor (or Assistant)

Council Employee

Other

Tell Us About Your Event(Required)

Date Event Starts(Required)

Time Event Starts(Required)

Date Event Ends(Required)

Time Event Ends(Required)

How Can We Reach You?

Your Email Address(Required)

Email Address Confirm Email Address

Your Phone(Required)

To Whom Do We Issue the Certificate?(Required)

First Last

Contact Information for Issuee

Their Email Address(Required)

Email Address Confirm Email Address

Phone Number(Required)

Address for Event(Required)

Street Address Address Line 2 City ZIP Code

Mailing Address if Different from Event Address

Street Address Address Line 2 City ZIP Code

Request for Certificate of Insurance

About You

How Can We Reach You?

Contact Information for Issuee

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