Student Accident Forms

Student accident coverage is available through your local participating school district. Please find your district below to determine the correct brochure and claim form. If you need assistance, please contact our office at (800) 481-2535.

Big Horn County District #1  Policy Number: SRG9145243 Effective Date: 8/9/2015-2016	Carbon County District #1 Policy Number: SRG9145242 Effective Date: 8/1/2015-2016	Converse County District #1  Policy Number: SRG9493136 Effective Date: 8/15/2015-2016
Converse County  District #2 Policy Number: SRG9146236 Effective Date: 8/13/2015-2016	Frontier School of the Bible Policy Number: SRG9145294 Effective Date: 8/19/2015-2016	Sheridan County District #3  Policy Number:  SRG9146248 Effective Date: 8/13/2015-2016
Sublette County District #9 Policy Number: SRG9146117-A Effective Date: 8/17/2015-2016	Washakie County District #1 Policy Number: SRG9145306 Effective Date: 8/12/2015-2016	Washakie County District #2 Policy Number:  SRG9146182 Effective Date: 8/1/2015-2016