ESCA Form

Event Information for ESCA's Societies and Affiliates 

The insurance that ESCA provides for its societies and affiliates is not applicable to all events. Please download, complete, and submit the following form prior to holding your event. If our agent, Brokerlink, determines your event is not covered by the existing insurance policy, additional coverage will be arranged. This may result in an additional insurance premium for your event. 

Right click here and select "Save link as" to download the form. 

Remember the location where the file is saved, as it must be opened from there. (Clicking "Open File" in your browser after downloading the form will not work, as the form cannot be completed in a browser window.)

NOTE: Acrobat Reader or Adobe Acrobat is required to complete the form on your computer. Click here to get Acrobat Reader if it is not already installed on your computer.