Basic Details

Area Of Aircraft Operations

UK and Europe
Worldwide excluding USA and Canada
Specific Country please state

Purpose of Use (please tick the appropriate usage)

Private Pleasure
Private Business
Instruction and Rental
Club Use
Any other use please state

Accident or Losses

Pilot Details

  Pilot 1 Pilot 2 Pilot 3 Pilot 4
Pilot's Name:
Date of Birth:
Licences/Ratings Held:
Total Hours:
Total Piston Engine Hours:
Make and Model Hours:

Other Details

Additional Information


By submitting this form I hereby declare that to the best of my knowledge and belief the answers to the foregoing questions are true and complete and that I have not withheld any information which might influence the decision of the Insurers with regard to this proposal. I agree that this proposal and declaration shall be the basis of the Contract between me and the Insurers if a policy is issued.