Membership in the Chicago Claim Association costs $75 per year. Complete the form below and click "next »" to enter your credit card information. Choose a username and password that will allow you to access your members' only benefits on the CCA web site. Required fields are noted in red.

Note, if you are an existing member and want to renew, login to renew your membership. If you're an existing member and do not know you user name and password to contact Susan McCullough at 309-826-8814 or susan.mccullough@verizon.net.

Thank you for choosing to become a member of the Chicago Claim Association.

CCA New Member Application
Your Name:
	First	Last
Username:
Password:
E-mail Address:
	(e.g., username@domain.com)
Your Title:
Company Name:
Address:
City, State:	, SELECT ONEAKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
Zip Code:
Telephone:
Fax:
How did you hear about the CCA?
Please describe your professional duties:
For those members who provide e-mail addresses, future notifications from the CCA will be routinely distributed via the e-mail address listed on the application. If you do not want your notifications by e-mail, they will be mailed via the U.S. Postal Service to the address listed on your application. Please check below if you want your notifications to come by the postal service.
	Send information via USPS.

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