MUSC













 
On Line Membership Form

 

Fill out the following form to become a member of MUSC:
Annual dues received on or before December 17th are $35.00.  Dues will not be accepted after December 17th.

Please forward your dues payment by check to our Treasurer, Chuck Colella at the following address:

MUSC Membership
C/O Charles Colella
Vericlaim
700 S. Flower St.
Suite 2310
Los Angeles, Ca 90017

You may also pay online with your Holiday Party reservation.
 

New Member Information:

 Name:

 Company:

 Title:

 Address:

 City:                               St:     Zip Code:
   
 Phone:                   Fax:
  
 Email:

 Describe your role 
 in Marine Insurance:
 

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Site Updated November 11, 2009
For questions, corrections, suggestions about this web site, contact WebMaster Bill Enger