Affiliate
Membership Application
Affiliate Membership is for those who want to enjoy OREP
benefits
but do not obtain their E&O insurance through OREP. (Benefits are included
when you purchase your insurance through OREP.)
Benefit Summary (find the complete list
online)
*
Access to
WRE
Premium Content Online with over
200 stories
($40 value)
(Print not included)
* Access to
Group Medical
Plans (Calif. residents only)
* A range of other healthcare programs including
Health Savings Accounts
nationwide
*
Mckissock Education
in 50 states - 10% discount for members and affiliates (Special
Packages
of coursework with up to 49 hours of approved CE will be
available soon at this link, check back when you need your
hours.)
* Volume
Pricing on Home, Auto, Workers Comp. and other Insurance
*
Corporate Savings - Save money with your favorite suppliers:
Office Depot, hp, FedEx, cingular, ect.
Download the
application
Affiliate Membership Fee: $50/1 year
Contact Information
Name:________________________________________________________________________
Company Name:
_______________________________________________________________
Mailing Address:
_______________________________________________________________
City: _____________________________ State:
_______________ Zip: _________________
Phone: _______________________________________ Fax:
___________________________
Email:___________________________________________________
NEW!
Fax Payment by Check! It’s Fast, Free and Simple. Here’s
how:
1. Complete your check payable to OREP for the total amount due
and attach below.
2.
Keep the actual check for your own records.
3. Sign the authorization below and fax the check with the
application to OREP: 619-704-0567
This check authorizes
OREP
to charge our bank account as per the attached check:
______________________________________________________ _____/_____/_____
Your
Signature Date
Signed
(
) If paying by fax/check: Attach
a check made out to OREP in this box and fax with application
to: (619)704-0567. For more information call: (888) 347-5273.
( ) If paying by Credit Card: please
complete information below. (A 2% convenience fee will be added to
all charges.)
CREDIT CARD: I approve OREP to deduct the total amount due.
Type of Card: ( ) Visa ( ) MC
Name on card:
____________________________________________________________________
Billing Address:
___________________________________________________________________
City: _____________________________________________State:______
Zip:_________________
Credit Card Number: ___________________________________________
Exp. date: _____/_____
Signature of
cardholder______________________________________________________________
Date signed _____/_____/_____
Please Mail or Fax completed application with payment to:
OREP 6760 University Ave. #250 San Diego, CA 92115.
Fax to: 619-704-0567 Call: 888-347-5273
www.orep.org
*
info@orep.org
OREP
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