Human services

Select an application below. Adobe Acrobat Reader must be integrated with your web browser to enable you to complete our applications and forms online.

Should you have difficulty printing or opening our forms online, please save the form to your desktop (select "Save As" or "Save Link As" by right clicking on the hyperlink to the desired form) and then open and complete the form locally using Adobe Acrobat.

Contact us should you have any issues and need a hard copy emailed, faxed or mailed to you.

Insurance agents
You must be an appointed agent with Markel to submit an application. For more information about how to become appointed with Markel, click here. If you are a direct customer, and do not have an insurance agent, we can provide you with the names of several who handle social service related insurance.

Please complete one of the following program applications in addition to an Acord application:
Human services
Camp insurance
Child care--for child care centers, preschools
Child welfare
Nature center

Supplemental Applications (in addition to the program application above)

Abuse and molestation
Accident medical
Animal shelter
Camp accident medical
Employment practices liability (EPL)

Food bank, warehouse
Not for profit management liability application - New business

Speech/hearing pathology and occupational therapy
Special events
Youth recreation accident medical

Return completed applications to:
Fax: 804-527-7966