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Pilots Application Form


Compulsory Questions,

please check the box if in the past five years you have ever been (or have pending):

 
 
 
 
 

Legal Defence- compulsory - £29.81

Standard Legal Defence is a compulsory cover, please select which of the additional options are required: 

 
 

Pilot Protection (compulsory) 

Please choose which level of cover you require

 
 
 
 

Personal Accident - Optional

Please choose which level of cover you require

Capital sums insured
 
 
 
 
 
 
Weekly Benefits
 
 
 
 
 
 
 
 
 
 
 
Payment Options - How do you wish to pay:*
 
 
 
 
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