Personal Optional Coverage Application 2026

1. Click ‘Get Form’ to open the Personal Optional Coverage Application in our editor.
2. Begin by entering your Last Name and First Name in the designated fields. This information is crucial for identification.
3. Fill in your Company Name and Company Position, if applicable. If you are self-employed, indicate that accordingly.
4. Provide your Mailing Address, City/Town, Province/Territory, Postal Code, and contact numbers including Phone Number and Cell Number.
5. In the section regarding your role, check the appropriate box that describes your status: director, employer, or self-employed without workers.
6. Enter your rate of compensation for personal optional coverage applications. Acknowledge this amount as it will be used by WSCC.
7. Specify the optional coverage required by filling in the 'From' and 'To' dates accurately.
8. Finally, print the form to sign it before submission. Ensure all information is correct before sending it to the provided address.

Start using our platform today to complete your Personal Optional Coverage Application effortlessly!