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Orient School - Students Group Personal Accident (GPA) Quotation
Personal Details
First Name / Corporate Name
Last Name
Mobile No.
Email Address
Which Kenya Orient branch do you want to be served from?
Select
ASS-ASSESSMENT CENTER
CHQ-CHQ
ELD-ELDORET
EMB-EMBU
HGS-HUGHES
HQS-HEAD OFFICE
KGL-KITENGELA
KKM-KAKAMEGA
KSI-KISII
KSM-KISUMU
KTD-KTDA
MCH-MACHAKOS
MRU-MERU
MSA-MOMBASA
NKU-NAKURU
NYR-NYERI
RKA-RUAKA
RNG-RONGAI
THK-THIKA
WST-WESTLANDS
Period of Insurance
Insurance Start Date
Insurance End Date
Cover Section
Cover Type
Select Cover Type
Plan 1
Plan 3
Plan 2
Basic Premium
Benefits
Do you wish to opt for Emergency Rescue Stabilization & Treatment on Site?
How many pupils/students does the school have?
Submit