Appointments 2 — RIZK insurance solutions

Get a quick quotation from us now

Name of school / institution / organisation

Name

First Name

Last Name

Contact Number

Mailing Address

Fill below for requests for quotation for RIZKcare only *

Number of Years of Coverage

Type of Device

Is this a Brand New Laptop?

Does your device come with AppleCare Plus ?

Original Purchase Price (w/o GST)

SGD

Additional Information

DECLARATION AND CUSTOMER'S DATA PRIVACY CONSENT

I/We confirm that I am/We declare that all the particulars given above are to the best of my/our knowledge true and correct.

I/We give consent for Rizk Insurance Solutions Agency Pte Ltd (“RIS”) and their respective representatives or agents to collect, use, store, transfer and/or disclose the information (including that provided by sources other than myself) concerning me/us and/or the claimant, to or with all such persons (including any member of the RIS or any third party service provider, and whether within or outside of Singapore and the Policyholder when claiming under a Group Policy) for the purpose of enabling RIS and their respective representatives or agents to provide me/us with services required of an insurance provider, including the evaluating, processing, administering and/or managing my/our and/or the claimant’s claims or the Policyholder Group Policy(ies) with RIS (as the case may be).

By pressing the submit button, I agree to the above.