Thank you for your interest in becoming an ICCIE Fellow.

The minimum requirements to become an ICCIE Fellow are:

The applicant must be an Associate in Captive Insurance (ACI) in good standing;

The applicant must have significant experience working full time in the captive insurance industry;

The applicant must have demonstrated significant commitment to the industry through service. This may be in the form of (but is not limited to):

  • Significant service through industry organizations
  • Unique contributions to the industry
  • Specialized industry research

The applicant must provide two letters of recommendation.

In order to process an ICCIE Fellow application an applicant must pay a (one-time) fee of $500 (refunded in full if the Fellowship is not granted).


To apply to be an ICCIE Fellow, please fill out the following form:


ICCIE Fellow Application Form


Applicant Name:_________________________________________________________________________________


Address (# and street, city, state, country, zip code): ________________________________________________________________

Telephone Number:__________________________________________

Email Address:__________________________________________________


In a separate “dossier document” (either as a Word file or PDF document), please outline:

  • Your work experience in the captive insurance industry; and
  • Your service in the captive insurance industry.


Please send this completed application, along with the above-mentioned dossier document, two letters of recommendation, and payment for $500 to:

2517 Shelburne Road, Suite 2
Shelburne, VT 05482

Or, via email, to (our office will contact you for payment arrangements).  Thank you for your interest in ICCIE!



Mitch Cantor
ICCIE Executive Director