INSURANCE REQUEST FOR INFORMATION
Name & Address *
Telephone Number *
Email Address *
Collection Point
Country of Destination *
Approx date of sending
Next Month
This week
Next Week
January
February
March
April
May
June
July
August
September
October
November
December
Type of goods *
Boxed Personal Goods
Personal Goods & Furniture
Furniture Only
Other please specify below
Goods will be Professionally Packed *
Yes
No
Don't Know
Approx Value of Shipment
£100-£500
£501-£1500
£1501-£2500
£2501-£5000
£5001-£7500
£7501-£10000
Over £10000 specify below
New option_8
Which service required
Sea Less Than Container
Sea Full Container
Airfreight
Europe By Road
Uk Storage Only
Previous Claims in the last 5 years *
No
Yes (please specify below)
Other Information eg high values
Questions marked * must be completed