Driver Insurance Questionnaire

driver insurance questionnaire

About you

First name *

Last name *

Email *

Lead traveller / booker

Lead traveller / booker full name *

Mobile Number *

Home address *

Nationality *

Date of Birth *

How many years have you held a driving license? *

Have you any physical or mental defect or infirmity which impacts your driving ability? *YesNo

Do you have any current convictions for any motoring offence (except parking)? *YesNo

Have you had any proposals declined, a policy cancelled or renewal refused or been required to pay an increased premium or had special conditions imposed by any motor insurer? *YesNo

Have you had any motoring accidents that have occurred in the last 3 years? *YesNo

If you answered YES to any of the previous four questions, please provide further information below.

Please upload a copy of your driving licence *

speak to our expert team

Our team are destination specialists with many years experience in creating holidays and can tailor make to suit you.

Call us on
+44 (0) 33 3339 6005

to discuss your plans or email
travel@celticroutes.co.uk

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drivEr insurance questionnAire

driver insurance questionnaire

drivEr insurance
questionnAire