Worldwide Assurance for Employees of Public Agencies Better Insurance.  Better Prices.  Better Value.SM

Order Your Free Information and Application Package We offer you free brochures that will explain all the advantages of WAEPA membership and will provide you with application forms. Free Brochures WAEPA Life Insurance Associate Membership Open Enrollment Additional Life Insurance Email Brochures to a Friend To have the Free WAEPA Information Kit sent to you via US mail, please fill in and submit the form below. We want to welcome you as a WAEPA Member! Please provide a home address only, due to past rejected mailings to office addresses. First Name: Last Name: Mailing Address: City: State:     Zip Code:   Phone:     Ext:  Date of Birth: Email: Agency Employed by: To request information regarding specific product(s), check the appropriate box(es) below:     Group Term Life Insurance (You must be less than age 65 to apply for Group Term Life Insurance) Click here for an online version     $25,000 or $50,000 Open Enrollment - Life Insurance (You must apply within 180 days of your hire date) Click here for an online version Click the "Submit" button below to submit this form on-line. You may fax this form to (703) 790-4606. You can also contact us TOLL FREE at (800) 368-3484. - Top -

Worldwide Assurance for Employees of Public Agencies 7651 Leesburg Pike, Falls Church, VA 22043 Phone (800) 368-3484 or (703) 790-8010   Email: info@waepa.org    Web: www.waepa.org This site developed and maintained by Covered Bridge Software Web:    www.CoveredBridgeSoftware.com Email: Info@CoveredBridgeSoftware.com