Shifflett Insurance, Inc.
3047 Center Point Rd.
Cedar Rapids, IA 52402

Toll Free: 800-584-7012
Fax: 319-398-7461

andy@shifflettinsurance.com


Offering daycare insurance in six states!

Apply now online for free!

There is no application charge and our application takes only a few minutes to complete. Simply download and print our application below, then fax it to our office. Our dedicated fax line is able to receive applications 24 hours a day, 7 days a week .


Shifflett Insurance Daycare Application
(application.pdf, 449KB) (Download Here)

Fax Line: (319) 398-7461

Note: You need Adobe Reader installed on your computer to view the application.
It is available for free by following the link provided below.