NYSCA Insurance Plan Applications
Print Applications
- General Liability/Medical Expense Enrollment Form (coverage effective 02/01/2021-01/31/2022)
- General Liability/Medical Expense Enrollment Form (coverage effective 02/01/2020-01/31/2021)
- Optional Coverages Questionnaire (D&O, Crime and Equipment)
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We accept faxed checks. Click here for special instructions on how to fax a check.