Certificate of Insurance Request Form

Certificate of Insurance Request Form
This form is used to request a certificate of insurance for events and troop meeting places.

Please submit this form 1 week in advance of event or troop start date.
Requester Information:
Service Unit #: *
Troop #: *
Requester's Name: *
Email Address: *
example@example.com
Certificate of Insurance Information:
Certification Type *

Troop Meeting/Event Cookie Booth
Name of Location (No Abbreviations): *
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Address: *
Street Address of Location
City: *
State: *
Zip Code: *
Comments:
Optional Specific Requirements Upload

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Cancel of
Please allow 3 business days to be processed. You will receive an email with your certificate attached. If you have any further questions, please contact: info@gsnypenn.org or 1.855.213.8555 option 2
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