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 https://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 Name
Last Name
Email*
Do you want us to call you? (xxx)xxx-xxxx
Are you part of a team? (Which?)
Organization name
Where is your team going?
Have we helped you/your group before?
- Yes
- No
- Don't know
Name of the Point of Contact/Team Leader?
Total value of trip?
The non-refundable, prepaid costs of trip
Require Trip Cancellation?*
Desired length of coverage?
Travel date-Start?
MM
DD
YYYY
Travel date-Return?
MM
DD
YYYY
Deductible Preference
Need rider for extreme sports?
- Yes
- No
About your team/group:
The number of participants (0, 3, ... , qty) on your team, based on their age.
Age of participants: 0-17
Age of participants: 18-29
Age of participants: 30-39
Age of participants: 40-49
Age of participants: 50-59
Age of participants: 60-69
Age of participants: 70-79
Age of participants: 80-above
Comments?
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.
Comments
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About your team/group: