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	We may send you information from time to time about insurance generally and special offers. If you do NOT want to receive it check and we'll only send details about this enquiry/policy.
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