Registration

Please print each of the following forms and mail to: 
 
Beverly L. Bemiss, CPCU, AU, AIS, CPIW 
C/O Capital District Insurance Community, Inc. 
P.O. Box 13291
Albany, NY 12212-3291 

E-mail:  reddybro@nycap.rr.com

Phone:  (518) 237-8000

FAX: (518) 237-0852   

2008 REGISTRATION FORM