Please fill in this form so that we can send you the policy documents and get your covered.Driver/BodaBoda infoFirst Name *Phone Number *What is your phone number?ID Number *Please enter your ID numberBeneficiary infoFirst Name *Phone Number *What is your beneficiary's numberBike or Car DetailsRegistration number *Please enter the number plate of your bike/car.Select cover duration *Daily Kes 10Weekly Kes 70Monthly Kes 300Yearly Kes 3,600How long do you need the cover for?Location *Please share your stage name or location Mpesa Confirmation code *Lipa na Mpesa to paybill 4080707, account number "your ID number", amount 300 and paste the mpesa code here.Referral codeEnter referral code from any of our partners. Skip if you don't have any referral GDPR *Yes, I agree with the privacy policy and terms and conditions.SaccoDo you belong to any saccoBuy CoverPlease do not fill in this field. Please do not fill in this field.
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