Below is a sample of the emails you can expect to receive when signed up to wcirb.
| Data Name | Data Type | Options |
|---|---|---|
| Choose which applies to you: * |  Text Box | |
| First name | Text Box | |
| Last name | Text Box | |
| Text Box | ||
| Phone | Text Box | |
| Home address | Text Box | |
| City | Text Box | |
| State | Text Box | |
| Zipcode | Text Box | |
| Choose which applies to you: * |  dropdown | Agent/Broker |
| State * | dropdown | Agent/Broker |
| State | dropdown | Agent/Broker |
| Question Topics * | dropdown | Agent/Broker |
| If you have a question about your experience modification, please provide the effective date of the experience modification. | dropdown | Agent/Broker |
Arts and Entertainment
Business and Industry
Computer and Electronics
Games
Health
Internet and Telecom
Shopping
Sports
Travel
More