US Windsurfing is not currently able to process Insurance online.
Feel free to print this application, make your insurance check payable to The David Agency and send to US Windsurfing, PO Box 1261, Hood River, OR 97031.
If this page does not include enough room for your needs, fill this form out several times, printing out as you go. You may also submit this information is any format that meets your needs. We just need to get the item, year build, make & model, serial number and amount of insurance & agreed valuation information for processing.
[Remember, you must be a current member of US Windsurfing to take advantage of this offer. ]
NOTE- Change print orientation in your browser to Landscape before printing....
| Name: | ||
| Address: | ||
| Phone: | ||
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Fax: |
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| E-mail: |
We will inform you by e-mail when we have processed your information with The David Agency |
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| US Windsurfing Sail number | ||
| Have you had any losses? |
yes - if yes, list on a separate piece of paper no |
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| Item | Year Built | Make & Model | Serial Number | Amount of Insurance & Agreed Valuation |
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| Total amount this page: | * | |||
| * Multiply the Total Amount of Insurance x 0.02 | Premium: | ** | ||
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**Issue your check for the premium amount you calculated or $100 (minimum premium) which ever is greater. Send check made payable to The David Agency to: US Windsurfing, PO Box 1261, Hood River, OR 97031. |
Check amount: | |||
NOTE- Change printer orientation in your browser to Landscape before printing....
| Enter any questions or comments:
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