Web Account Application

MWCIA reserves the right to refuse or revoke an account's active status for failure to meet or maintain member/subscriber guidelines, failure to pay required fees, or for other reasons deemed appropriate by MWCIA.

Please provide the following information and then click "Next" to proceed:

MEMBER APPLICATION: A Member is an insurance company who is registered with the MWCIA and licensed to conduct business in the State of Minnesota.

  • Please choose the following Web Account type:
    •          Member Web Account


    SUBSCRIBER APPLICATION: A Subscriber is one who is a current employee of an insurance agency or acting on behalf of an insurance company.

  • Please choose one of the following Web Account types:
    •          $1,000 Platinum - Unlimited access to experience modification worksheets for one year
             $150 Silver - Limited to 20 experience modification worksheets
                                    *Additional sets of 20 worksheets may be ordered for $150 (each set of 20)*

  • Please List E-Mail Addresses For Additional Personnel Who Wish To Receive Newsletters And Circulars
    		•
            Please select No. of Email Addresses: