You will need the most recent version of Adobe Acrobat Reader to view and print the LifeRing enrollment form.

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Then, to enroll in LifeRing, click below:

Please read the Important Notice before downloading the application.

Application form for LifeRing Group Term Life Insurance Plan

Please print the appropriate form, complete it in writing, and mail it to:

LifeRing Term Life Insurance Program P.O. Box, 152501 Irving, TX 75015-2501

Do NOT send money. Your credit union account that you designate will be billed when your coverage is approved.
Alternatively, you may request an application by calling us at our toll free phone number below.
If you have questions, please call your Plan Administrator weekdays between 8:00 a.m. and 5:00 p.m., Central Time at:

1-800-223-8646

30 Day "No Obligation" Free Look
Once approved for coverage, you will be sent a Certificate of Insurance. If you are not completely satisfied with the terms of your certificate, you may return it, without claim, within 30 days of receipt. Your coverage will be invalidated and you will receive a full refund of any premium paid, no questions asked.