Charity Travel Insurance Enquiry

1Organisation Details

2Contact Details

3Travel

4Information

Organisation Details

Organisation to be insured*

Annual Turnover*

Number of employees, trustees & volunteers*

Describe the aims and core activities of the organisation*

Address*

Postcode

9VZ2-JSWC-S4HE-3RNU

DaviDoyle882157

Select an Address:

Street Address Address Line 2 City County

Insurance and individual history

I confirm these statements are true.

The organisation has not:
• been refused insurance cover
• had cover cancelled
• had special terms applied by an insurer

None of the organisation’s trustees, directors, partners, committee members, either as private individuals or in connection with any business or organisation have:
• been the subject of any adverse publicity in the last 5 years, or anticipate being the subject of any adverse publicity in the next 12 months
• been designated or specified under the Sanctions and Anti-Money Laundering Act 2018, or any similar sanctions list provided by the United Nations, European Union or the United States of America
• ever been convicted of a criminal offence other than motoring offences
• ever been declared bankrupt
• any unsatisfied County Court Judgement against them
• been the subject of a prosecution, or notice of intended prosecution, under any health and safety at work, consumer protection or environmental legislation or investigation in the last three years by the Charity Commission, Revenue & Customs or any other regulatory body

Insurance Start Date*

DD slash MM slash YYYY

When are you looking for the insurance to start?

Contact Details

Name*

First Name Last Name

Phone*

Alternative Contact Number

Email Address*

Enter Email Confirm Email

Travel

What is your estimated travel pattern for the next 12 months?
Each person travelling equates to one trip i.e. 5 persons travelling on the same trip = 5 trips

Where do you intend to travel in the next 12 months? (select all that apply)

Internal*

Europe

USA/Canada

Rest of World

Area of Unrest**

* Internal trips must include an overnight stay &/or an internal air flight. **These are countries or regions to which the Foreign and Commonwealth Office advise against ALL travel: www.gov.uk/foreign-travel-advice. Details should be provided below.

No. of Internal* Trips*

Average Duration of Internal* Trips*

No. of Europe Trips*

Average Duration of Europe Trips*

No. of USA/Canada Trips*

Average Duration of USA/Canada Trips*

No. of Rest of World Trips*

Average Duration of Rest of World Trips*

No. of Trips to Areas of Unrest***

Average Duration of Trips to Areas of Unrest***

Additional Information/Requirements

Please provide any details about countries or regions you intend to travel to which the FCO advise against, and any other requirements for the policy.
Include such as arrival/departure airports, specific locations, security and escort arrangements, whether travellers will move around or stay at one location, and whether you have travelled to this location before.

Claims Experience

Claims History

Please provide details of all claims in the last 3 years if insurance has been purchased for the period.

Privacy

Data Statement*

I agree to the data statement.

Any data we collect, including any personal and sensitive data, will only be information necessary solely to provide a quotation and policy. We will share your data with insurers and other bodies involved, for the purpose of arranging and administering your insurance. If you cannot provide all of the information requested, we will be unable to quote or offer cover. We never share your data with anyone outside our organisation for any marketing purpose.

Receive occasional emails with insights and resources on risk management

Yes

How did you hear about us?*

Special Requirements

Do you have any special requirements in the way we deliver our service to you?*

Yes

If yes, what special requirements do you have, that will help our team deliver our service to you?*