WIND FELLOW DESIGNEE DIRECTORY
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User ID
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First name
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Last name
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Company
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Address
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City
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State
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Zip
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Website
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Email
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Phone
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Fax
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Mobile
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Job Title
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Occupation
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Accountant
Adjuster - Company
Adjuster - Independent
Adjuster - Public
Agent - Casualty
Agent - Property
Attorney - Defense
Attorney - Corporate Counsel
Attorney - Policyholder
Carrier
Consultant
Contractor
Engineer
Government
Other
Please list "other" occupation here:
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How did you hear about WIND?
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Conference promotional email
Attended conference
Colleague/supervisor
Industry connection
LinkedIn
Facebook
Twitter
If you were referred to WIND, please provide the name of who referred you.
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Who do you primarily get your First Party Property work from:
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Insurance carriers
Policyholders
Both Insurance carriers & Policyholders
Neutral
Adjuster Type
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Carrier
Independent
Public
N/A
WIND Member Application Terms and Conditions
is
Yes
No
Certification Designation (Professional/Fellow)
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is
does not contain
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WIND Certified Umpire Directory Expiration Date
on or before
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on or after
empty
any date
this month
this year
last month
last year
is not
WIND Certified Umpire Class Completion Date
on or before
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on or after
empty
any date
this month
this year
last month
last year
is not
Educational/Industry Experience Background
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Other Relevant Information Relating to Ability to serve as an Umpire
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Professional Licensures
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Attorney
Building Contractor
CPA/Accountant
Engineer
General Contractor
Independent Adjuster
Insurance Adjuster
Insurance Agent/Broker
Mediator
Other (Specify)
Public Adjuster
Other Professional Licenses and Credentials
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Insurance Company Adjuster - Year Issued
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Insurance Company Adjuster - License Number/State
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Independent Adjuster - License Number/State
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Independent Adjuster - Year Issued
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Public Adjuster - License Number/State
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Public Adjuster - Year Issued
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Attorney/Defense - License Number/State
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Attorney/Defense - Year Issued
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Attorney/Neutural - License Number/State
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Attorney/Neutural - Year Issued
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Attorney/Policyholder - License Number/State
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Attorney/Policyholder - Year Issued
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Accountant/CPA - License Number/State
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Accountant/CPA - Year Issued
contains
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Engineer- License Number/State
contains
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Engineer - Year Issued
contains
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Agent/Broker - License Number/State
contains
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Agent/Broker - Year Issued
contains
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General Contractor - License Number/State
contains
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General Contractor - Year Issued
contains
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Building Contractor - License Number/State
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Building Contractor - Year Issued
contains
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Mediator - License Number/State
contains
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empty
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Mediator - Year Issued
contains
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Other Professional Licensure - Year Issued
contains
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Other Professional Licensure - Current License?
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is not
Yes
No
or
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