Chartis Travel Insurance Booking Forms

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+202 16119 (or Nearest Branch) 0900-2200
+202 0101401367 - 0122192995 1700-0800

Travel Insurance Booking Request

All fields marked with * are required.

Travel Insurance Details

Insurance Type *

Quick Quote

No. of Insureds:

18 years - 45 years
46 years - 65 years

Plan Type *

Zone *

Coverage Period *

Coverage Start Date *

Coverage End Date *

Insured Information

* Please write the names as they appear in the passport

First Name *	Middle Name *	Last Name *

Gender *	Date of Birth *	Passport Number *

Policy Cost 0.0 Policy Tax 0.0
Total Policy Cost 0.0

Primary Insured Contact Information

Phone Number *

Mobile Number

Email Address *

Address *

City

Delivery Information

Kindly enter your delivery information below. Our delivery service is offered in Egypt only.

Address *

City *

Delivery Schedule *	EGP 25 Morning delivery starts from 10:00 AM till 1:00 PM Everyday except Friday Delivery within 2 days

Privacy Statement

We understand that making purchases online involves a great deal of trust on your part; we take this trust very seriously, and make it our highest priority to ensure the security and confidentiality of the personally identifiable information ("PII") you provide us. (PII includes information that can be linked to a specific individual, such as name, address, phone number, or email address.)

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