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Country where the holiday home is based *
Postcode of holiday home (or region if overseas) *
Usage of the holiday home *
Type of property *
Approximate year of construction (yyyy) *
Total floor area (approx)
Wall construction *
Roof construction *
% of the roof that is flat *
Is the Building listed (or its foreign equivalent) *
Type of burglar alarm fitted *
Buildings sum insured (£) *
Outbuildings and/or permanent structures sum insured *
Swimming pool sum insured (if applicable) *
Is accidental damage recover required on Buildings?	YesNo
Contents sum insured (£) *
Is accidental damage recover required on Contents? *	YesNo
Title *
Proposer first name *
Proposer surname *
Your occupation/job *
Your employers business *
Proposer date of birth (dd/mm/yy) *
Your home address postcode *
House number/name
Is the holiday home currently insured? *	YesNo
Number of claim free years
Number of claims in last 5 years
Value of largest claim in last 5 years (£) *
Cause of largest claim in last 5 years
Contact email address *
Contact telephone number *
I wish to receive details of future offers/promotions	YesNo
Date cover required *