Personal Effects - Signup Form

No cover for cell phones, glasses or any items left in a car or bus

You are now on a Secure Server.

Personal Details
Student's First Name *
Student's Last Name *
School *
Passport Number *
Phone *
Address In Israel *
Email  *

Period to be covered:

Start Date *
End Date *

Items to be Covered:

  • Cover: All contents are covered in the dorm / apartment 
    for fire, water damage, theft and arson. (up to $20,000)
  • All Risks: Specified items (*) are covered both inside & outside
    the dorm / apartment up to policy limit ($4,000)
Items Approx. Value $
Clothing
Books
Musical Instruments
Other Items
* Photographic Equipment
- anything over $150
* Electronic Equipment
(stereo, laptop etc) - anything over $150
* Jewelry
- anything over $150
* Tefillin
Total Sum Insured * $
All Risks total (*specified items)  * $
All-Risk Cover Type * Up to $4000, cost: $100
Billing Details
Credit Card Type *
Credit Card Number *
Credit Card Expiration * /
Card Owner *