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Boat & Watercraft Insurance Quote

	* Indicates a required field.
First name	*
Last name	*
Address	*
City	*
State	MI *
ZIP Code	*
Primary contact number	*
Secondary contact number
Fax number
Email address	*
Re-enter email address	*

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Boat and outboard motors you own: Year/Make/Model Length Horsepower

Driver information: Date of birth Boating courses completed Boat and motor vehicle violations (past 5 years) Details on all boat accidents (past 5 years)

Occupation

Select from the list below: Teacher Retired teacher Professor Substitute teacher ------------------------------------ Administrator Principal/Asst. superintendent Educational instructor Educational counselor Other education type Other administrator type School aide School bus driver School bus mechanic School cook School kitchen worker Custodian Secretary Librarian Library clerk Nurse Psychologist Social worker Other school support staff ------------------------------------ Educational Credit union member Teaching hospital employees *

Name of employer

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What prompted you to request a quote today?	Select one: Brochure/Flyer Direct mail offer Education conference Email Online search engine Referral Yellow pages Currently have Meemic insurance *
Preferred quote code (if any)

The number of boats you will be quoting	Select One 1 2 3 4 5 or more *
The number of outboard motors you own	Select One 0 1 2 3 4 5 or more *
The number of boat operators in the household	Select One 1 2 3 4 5 6 7 8 9 or more *

Coverage is subject to all policy terms, conditions, exclusions, and limitations. Subject to underwriting eligibility requirements. Insurance underwritten by Meemic Insurance Company or non-affiliated insurance companies through our affiliate agency, ACG South Insurance Agency, LLC. Contact us for more details.