Insurance UCPA - VACANCES B2C

Language :

Policyholder

Last name *

First name *

Email *

Phone number *

Address *

Postal code *

City *

Childminder

The name of the person looking after your children.

Work replacement

The name of your work replacement.

Your trip

Destination country * Commencer à écrire et sélectionner un pays parmi la liste suggérée.

Trip dates

Program enrollment date

Date on which you booked your stay or made your registration.

Any event occurring between the date of reservation of your stay (registration) and the date of subscription to this insurance contract, will not give rise to any reimbursement or compensation..

Internship start date *

Internship end date *

Travellers concerned by the insurance

Number of travellers :

Pour renseigner votre groupe : téléchargez le fichier modèle ci-dessous, remplissez-le, et envoyez-le (étape 2) pour ajouter des participants.

Attention ! Cela ne fonctionnera qu'avec le modèle de fichier de rooming fourni.

Télécharger le fichier de rooming :

Modèle de fichier

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At least one traveller is expected to take out insurance

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