Restuarant Insurance Proposal Form

Full Name Of Proposer*:
(including all trading names, group companies and subsidiaries to be covered by the policy)

Address*:

Postcode*:

Telephone*:

Email*:

Renewal Date*:
(from which cover is required)

Current Insurer*:

If This is a Fast Food Restaurant, Are You a Member of The Federation Of Fish Fryers:

NoYes

How Long Have You Been Trading?*:

Number Of Years Experience Within This Or An Associated Industry*:

Please note, all fields marked * are mandatory.

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