Account Registration

*Note: Membership to this site is public. Once your account information has been submitted, you will be granted immediate access to the site. All fields marked with a red asterisk are required. (Note: - Registration may take several seconds. Once you click the Register button please wait until the system responds.)

Enter a user name. It must be at least five characters long and is must be an alphanumeric value.
Enter your password.
Re-enter the password to confirm.
Enter a display name.
Enter a valid email address.
Enter a first name.
Enter a last name.
Please provide your Date of Birth.
RadDatePicker
Open the calendar popup.
Please refer to the bottom of the page on how to locate your AFSA member ID.
Please select a Secret Question.
Please provide a Secret Answer
I would like to receive new product information via email when available.
Enter the Postal/Zip Code part of the address.


To register for an AFSA Member Insurance Program account, you will need your AFSA member ID number, which can be found on your AFSA member ID card. If you do not know your ID number or need further assistance, please call AFSA at 800.638.0594.