Term Life Insurance

This is generally used to protect your family. It can also be used for Business Protection reasons.

Please select the type of cover you require:
	Life Insurance Only
	Critical Illness Cover Only
	One Policy Covering Both Life Insurance & Critical Illness Cover

Your policy requirements:
How much do you want to be insured for?	£
How many years do you want to be insured for?
Do you require the amount of cover to remain level or decrease over the term of the policy?

Personal Details
	First Person Covered:	Second Person: (if applicable)
Name
Date Of Birth	(dd/mm/yyyy)	(dd/mm/yyyy)
Gender
Has this person smoked any tobacco products in the last 12 months?