To pay by check, please fill out the form below and send your payment along with a copy of this form to:
Insurance Federation of New York, Inc., P.O. Box 9001, Mt. Vernon, NY 10552. To pay by credit card, please click here.

 Corporate A: Corporations or firms w/ over 50 employees and are entitled to add 10 names to membership listing - $1,200.00

 Corporate B: Corporations or firms w/ under 50 employees and are entitled to add five (5) names to membership listing - $650.00

 Not-for-profit: Not-for-profit or professional associations or organizations Not-for-profit Members entitled to add three (3) names to membership listing - $325.00

 Individuals: Individuals who are self-employed or unaffiliated with a company $175.00

 Emerging Leaders - Younger emerging leaders in the insurance, reinsurance and allied fields who are not currently part of the membership listing of a corporate or not-for-profit IFNY Member - $50.00

Additional Member Names (Include name, email, and separate with a comma):

Years in the industry
Insurance designation(s)

 Underwriting
 Reinsurance
 Accounting and Finance
 Legal/Regulatory
 Actuarial
 Agency/Brokerage
 Risk Management
 Claims
 Advisory
 Business Development
 Rating Agency
 Industry Organization or Publication

Other: