SIAI

GUN

INSURANCE

ONLINE

APPLICATION

Welcome to Sportsman's quick and easy online application for Gun Insurance. You must be a member of the ATA, NSSA, NSCA, SCI or SCTP/SPP to qualify for this insurance. Simply follow the instructions below to complete your application. For more information or to review our FAQ section, please select one of the links to the right.

The application has been divided into three sections:

Section One Personal Information and the Basics

Section Two Information on the items you want to insure

Section Three Payment information

If you have any questions before you start, see the information at the right or give us a call at

800 925-7767. Otherwise, click on Section One below to get started.

Let's start with your information and basics

PROFILE (click arrow to collaspe Profile section) back to top

Add the items you want to insure

GUNS, CASES and ACCESSORIES (click arrow to collaspe this section)back to top

Manufacturer	Model/Submodel/Grade	Caliber/Ga.	Serial#	Modifications	Value

				Total Guns/Cases Value	$
(Select check box, then click to delete)

CUSTOM WORK (click arrow to collaspe this section) back to top

For Gun #	Manufacturer/Gunsmith	Description	Value

		Total Custom Work Value	$
(Select check box, then click to delete)

SCOPES and BINOCULARS (click arrow to collaspe this section) back to top

Manufacturer	Model/Power	Serial #	Value

		Total Scopes/Binoculars Value	$
(Select check box, then click to delete)

Review and payment



TOTAL INSURED VALUE	$
x .0125	$ Premium Estimate
	($25 minimum)


Please answer the following question: Are you travelling with your guns within the next 48 hours? Yes No
If yes, call us before applying.

Please complete this form
	Association
	Member Number
	* First Name:
	Middle Initial:
	* Last Name:
	* Address1:
	Address2:
	* City:
	* State:
	* Zip Code:
	Home Telephone:	(999)999-9999
	* Day Telephone:	(999)999-9999
	Mobile:	(999)999-9999
	Fax:	(999)999-9999
	* Email Address:
	* Validate Email Address:

	* 1. Have you had any guns lost/stolen in the last five years? Yes No
	If yes, please explain:
	* 2. Do you have a central alarm system (fire and burglary?) Yes No
	* 3. Do you have a gun safe? Yes No
	4. Did you secure values from a phone conversation with us? Yes No
	* 5. Confirm that you have taken possession of all items scheduled for insurance. Yes No
	(Coverage is not available for items unless you have taken possession of them.)
	* Required fields