Wedding insurance Application

Weddingsurance Proposal request Form The wedding insurance standard package costs £55.00 including IPT Please use this form for wedding insurance.
Your name
E-mail address
Address line 1
Address line 2
City
County
Post code
Telephone No.
Wedding Date
Extra Benefits	Marquee Hire? £
Brides Name	Age
Grooms Name	Age
Also cover may be available for marquee hire or different cancellation limits.
Any specific demands or needs	None
	Declaration I have completed the form to the best of my knowledge and belief. I have made a full disclosure of all material facts. I have read and understood the Important information below. I understand that there is no cover in force until confirmed by B. Portwood & Co Ltd, a satisfactory proposal form completed and accepted and payment of the premium made - either in full or an instalment plan set up acceptable to B. Portwood & Co Ltd.

Weddingsurance Proposal request Form