Membership Application

Please use the convenient online registration below to submit your application directly to NWOSIA.

Mail payments to

                     Northwestern Ohio Self-Insurers Association

                     P.O. Box 350158

                     Toledo, Ohio 43635-0158

Online registration

Membership Charge:                                                $75.00 First Designee

                                                                                          $25.00 Each Additional Designee

Note: Please fill out the fields marked with an asterisk.