REQUEST FOR QUOTATION

MEMBERSHIP ELIGIBILITY
Minimum of 10 Principal members to qualify for a corporate account

PRINCIPAL MEMBER
Employee who actively works full time and has attained the age of 18 years old up to age 65

DEPENDENTS
For Married Principal Member

  1. The legal spouse at least 18 years old up to age 65
  2. Legitimate and/or legally adopted children who have attained the age of 90 days up to 21 years of age unmarried and unemployed and living under the same roof as the principal member

For Single Principal Member

  1. Parents up to age 65, unemployed and dependent upon the principal member
Brothers and sisters who have attained the age of 90 days up to 21 years of age who are not gainfully employed, unmarried and are living under the same roof as the principal member

CORPORATE/GROUP SURVEY FORM

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