Short-Term Team Pg 2 of 2: This is it! To offer your team/group the best price and the most accurate quotes for your trip/project, carriers need the following information. (You can also Skype us at 'goodneighborinsurance' or speak with us at 480-813-9100 or toll-free 866-636-9100 for an immediate answer!) Did you know: You can get exact quotes from the links at http://www.gninsurance.com/short-term-team/ and even save your progress or bookmark a particular quote page? We also offer contracted plans/rates for groups that travel overseas regularly/every year, as well as a free branded webpage where your participants can sign up for themselves for specific plan(s) of your choice. Tell us a little more about your team/group:First NameLast NameEmail* Do you want us to call you? (xxx)xxx-xxxxAre you part of a team? (Which?)Organization nameWhere is your team going?Have we helped you/your group before?YesNoDon't knowName of the Point of Contact/Team Leader?Total value of trip?The non-refundable, prepaid costs of tripRequire Trip Cancellation?* Desired length of coverage?Travel date-Start? MM DD YYYY Travel date-Return? MM DD YYYY Deductible Preference$100$250$500$1000$1500$2500$5000Need rider for extreme sports?YesNoAbout your team/group:The number of participants (0, 3, ... , qty) on your team, based on their age.Age of participants: 0-17Age of participants: 18-29Age of participants: 30-39Age of participants: 40-49Age of participants: 50-59Age of participants: 60-69Age of participants: 70-79Age of participants: 80-aboveComments?Lastly, how did you hear about us?We're open 8:00-17:00 MST Monday-Friday. On work days we provide quotes within 24 hours, and usually much sooner than that. If your request is submitted over the weekend, we will get a quote to you before the end of the work day on Monday.We send out a quarterly helpful, money-saving e-bulletin, as well as updates, to keep you up-to-date regarding changes to policies, explain new benefits, as well as help you save money and stay safe while traveling. If you do not wish to receive our quarterly newsletter, you can say so here, or you can wait and unsubscribe at any time by using the link provided at the bottom of each newsletter. Rest assured - We never share or sell our lists. Ever.Get the e-Bulletin 4X a year!YesNoPhoneThis field is for validation purposes and should be left unchanged.