Crew Van Enrollment

You are insured for accidental death and accidental disability benefits if you are being transported by a railroad owned vehicle.

There are some options for you to complete the enrollment:

1. Click Here to apply or

2. Print out the form below, fill it out, sign it, and fax it to (435) 688-1338.

Crew Van Flyer and Application
3. If you have Adobe Fill n Sign, you may fill it out that way and email it to us.