GEN Complementary Service Sign Up Form

 

Please fill up the required info below and our planner will contact you for policy drop off soon:

 

Your Name *

Your Email *

Your Contact *

I understand that you’ll contact me to arrange for policy drop off.*

By providing your personal data in the field(s) above, you hereby consent to the collection and use of personal data to contact you, by way of telephone calls, SMS/MMS and emails for the purpose of attending to your enquiries. Please ensure that you are the user and/or subscriber of the telephone number(s) and/ or email address(es) provided. We dislike spam as much as you and will never rent or sell your information. By providing your personal data in the above field, you agree to the terms of use.