Registration

Become a Self-Insurance Service Provider Member

Become a selfinsurancemarket.com service provider member today and get the following benefits:

Entry in the selfinsurancemarket.com Service Provider Directory with full company description.
Use the Business Inquiry Service to source self-insurance solutions for your clients and find new partners.
Let companies and other Service Providers source your specialist services and contact you when they need help.
Respond directly to companies who post Business Inquiries on the site.
Use our Risk Transfer Inquiry Service.

SERVICE PROVIDER APPLICATION

Click here to see our membership information

Please enter a Username (7 -20 characters) *

Job Title *

Please enter a Password (7 character minimum) *

Company Name *

Confirm Password *

Company Address *

Title *

City *

First Name *

State, County or Province *

Last Name *

Country *

Email *

Zipcode or Postal code *

Phone *

Business Inquiry Email (this is the email to which any inquiries will be sent) *

Page name format * This will create your own unique page at selfinsurancemarket.com which will show up in search engines. Please enter your company name with hyphens in between separate words (e.g. company-name)

Become a Self-Insurance Service Provider Member

SERVICE PROVIDER APPLICATION

Select Membership

Select Membership