Request a quote from Lockton Affinity

To receive an indication of what our coverage will look like for your organization, please answer the following questions. We will reply with a quote within 3 business days.

Council name *

Council state *
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Number of active members *


Desired effective date *


Have you had any claims in the past five years? *


Contact name *


Contact phone number *


Contact email address *