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Membership Update / Renewal Form

Please enter your information below and submit to FNQ Volunteers Inc.

Effecting and Maintaining Insurance Policies

This is compulsory for all organisations (copies of Certificate of Certificates are not required for Membership Renewals).

The organisation named below has effected and agrees to maintain Certificates of Currency of both Public Liability Insurance and Personal Accident Insurance for volunteer workers and agrees to provide FNQ Volunteers Inc with copies upon request.

It is FNQ Volunteers Inc policy not to refer volunteers to organisations that are not insured. The organisation agrees to notify FNQ Volunteers Inc immediately if insurances lapse, cease or change.

Organisation Name: *
Public Liability Insurance (PL)
PL Insurer's Name: *
PL Broker (if applicable): *
PL Expiry Date: *
PL Policy Number: *
Volunteer Personal Accident Insurance (PA)
PA Insurer's Name: *
PA Broker (if applicable): *
PA Expiry Date: *
PA Policy Number: *
E-mail: *
Web Site Address (if applicable):
Contact Person for Membership: *
Position within Organisation: *
If you have a Volunteer Coordinator, please state Name (otherwise N/A): *
Volunteer Coordinator's Contact Number (if applicable):
Volunteer Coordinator's E-mail (if applicable):


Name: *
Position: *
Date: *

By submitting this form, I confirm that the above details are correct and that I have the authority to pass this information to FNQ Volunteers Inc.

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