Adjuster Membership Application

Raleigh Claims Association Membership Application

You can complete the web form below or print the application from this file and submit it via mail.

Membership may be granted to persons professing connection on behalf of insurance companies,
independent adjusting companies and any other person holding a North Carolina Property and Casualty
License with investigation, adjustment, or examination of insurance claims and losses, except such
persons as hold themselves out as attorneys practicing independently.

Your Name

License(s) Held

Professional Designation(s) (CPCU, AIC, etc.)

Length of Time Adjusting

Your Email (All meeting notices are sent only via email.)

Home Address

Home Telephone

Cell Phone

Job Title

Employer / Company Name

Company Mailing Address

Work Telephone

How did you become interested in RCA?

Did anyone recommend RCA to you?

Are you interested in helping Board members with events (i.e. Golf Outing, Christmas Party)?
YesNo

Are you interested in serving on the Board of Directors (2+ years of RCA membership required)?
YesNo

You can pay your $10.00 membership dues right now via Paypal by clicking “Buy Now”:





Or you can mail your $10.00 dues payment to us at the address below:

Raleigh Claims Association
P.O. Box 10183
Raleigh, NC 27605-0183

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