VIS - Volunteers Insurance Service®

Volunteer Insurance Quote Request

Complete the form below. Your browser fills in the official quote request PDF on your own device (nothing is stored on this site); then email it to [email protected]. A non-binding quote will be sent to the email address provided. Prefer paper? Download the blank form (PDF).

* required


Street Address

Mailing Address (if different from Street)


 
 

Coverage may be effective the first day of a future month. All policies expire July 1. Policies may then be renewed for the standard 12-month term beginning July 1.

Volunteer Accident
Volunteer Excess Liability
Volunteer Excess Auto Liability
Court Referred Accident
Work Release Accident

Please note: a web page cannot attach files to an email. Email my quote request downloads the filled PDF and opens your email program — attach the downloaded PDF before you press Send. (Where available, Share / email with PDF attached attaches it for you.)


       

Please email the completed quote request to: [email protected]. A non-binding quote will be sent to the email address provided.
Acrisure Mid-Atlantic XS Program Insurance Agency, LLC
1265 Drummers Lane, Suite 300 | Wayne, PA 22192
703-778-7306  |  Rev 6/2026