International Campaign

Request form Higher Insurance

Title

Mr.

Mrs.

Company

First name*

Last name*

Company name*

Email address*

Depot number*

Parcel number*

Shipping date*

Insured amount*

Choose

€ 520 - € 1.000

€ 1.000 - € 1.500

€ 1.500 - € 2.000

€ 2.000 - € 2.500

€ 2.500 - € 3.000

€ 3.000 - € 3.500

€ 3.500 - € 4.000

€ 4.000 - € 4.500

€ 4.500 - € 5.000

€ 5.000 - € 5.500

€ 5.500 - € 6.000

€ 6.000 - € 6.500

€ 6.500 - € 7.000

€ 7.000 - € 7.500

€ 7.500 - € 8.000

€ 8.000 - € 8.500

€ 8.500 - € 9.000

€ 9.000 - € 9.500

€ 9.500 - € 10.000

€ 10.000 - € 10.500

€ 10.500 - € 11.000

€ 11.000 - € 11.500

€ 11.500 - € 12.000

€ 12.000 - € 12.500

€ 12.500 - € 13.000

Parcel content*

Sensitive good**

Premium amount € 0,00

Add parcel

Total amount to be invoiced:

€ 0,00

* Mandatory fields

** In this form 'Sensitive goods' are defined as follows (this list is not restrictive): computers and their accompanying screens, mice and accessories, video and DVD players, hi-fi stereo equipment, cameras, mobile telephones(GSMs), GPS, MP3 players, television sets, entertainment sets (e.g. games consoles), external hard drive discs, printers, photocopiers, fax machines, tickets (entertainment, sport events, transport), gift vouchers and alcohol.

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