MS Rural Water Association

This form is for the MSRWA and its affiliate systems. This is designed for anyone or system who’s a part of the MSRWA.


You have already been approved for an individual life insurance policy just by being apart of the MSRWA. The age restrictions and rules are below. Please fill out the information below as accurately as possible. One of our team members will be reaching out to you within 24 hours.

Age Restrictions for Guarantee issue. 18-50 elligible for 100k, 51-60 eligible for 75k, 61-70 eligible for 25k.

Water System Affiliation





Contact information