For your convenience, NAHU Chapter D&O applications are available in a PDF format that can be completed electronically or printed and completed manually.

To complete an interactive application and email directly to the NAHU Chapter D&O program:

1. Click here to access the appropriate form for your state
2. Save the form to your desktop
3. Complete the form at your convenience
4. E-mail completed form to NAHUD&O@locktonrisk.com

To print form, complete and fax/mail to the NAHU Chapter D&O program:

1. Click here to access the appropriate form for your state
2. Print the form
3. Complete the form and:
   a. Fax to 913-652-7599 OR
   b. Mail to:

   NAHU Chapter D&O Liability Program
   P.O. Box 410679
   Kansas City, MO 64141-0679