Membership Application and Renewal

GWCA (Georgia Workers’ Compensation Association) continues to work diligently to assure that Georgia employers are represented in every aspect of the workers’ compensation system. With the help of all our members, we have been able to ensure continous improvement in the workers’ compensation process, while maintaining a reasonable cost.

Annual dues for GWCA members are based on the number of employees each member has in Georgia: 1 to 300 employees: $335/year  |  Over 300 employees: $475/year

Pay by credit card will be available once the form has been submitted.
Greeting:
Name:
Company Title:
Business Name:
Address:
City:
State:
Zip
Email:
Work Phone
Fax Number
Number of Employees in GA:
Select Membership Type:
Associate Member: Any person, firm, corporation or other entity specifically in business as a vendor of products or services related to workers' compensation.
Employer Member: A company, self-funded pool, or other employer covering its workers compensation obligations through self-insurance or commercial insurance.
To prevent spam, please enter the alpha-numeric code before sending your application.
Other:
I am RENEWING my membership.
Include my information on the website/member directory.
I prefer to pay by check.
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Name of person (or entity) on credit card if not paying by check
NOTE: Dues to GWCA are not deductible as a charitable contribution, but may be deductible as an ordinary and necessary business expense. However, 40% of your dues is not deductible due to GWCA lobbying activity. Insured employers are eligible to join GWCA as associate members.
The service my business provides is: