2018 Washington Youth Tour Electric Cooperatives of Arkansas

Designation of Beneficiary Form
  • Arkansas Electric Cooperative Corporation purchases accident insurance coverage for each Youth Tour participant that is effective from the time the participant leaves his/her residence to participate in the tour until he/she returns to Little Rock. This form names a beneficiary for the $10,000 benefit.

  • do hereby designate:

  • as my insurance beneficiary during the 2018 Electric Cooperative Youth Tour during the week of June 8-14, 2018.

    I understand that this insurance, purchased by Arkansas Electric Cooperative Corporation will be in effect from the time I leave Little Rock, Ark., on said Youth Tour until the time I return to Little Rock, Ark., from Washington, D.C., on said Youth Tour.