>Teacher Absence Insurance
     
  City & General Direct (UK) Ltd. 1 Stonegate Road, Leeds, LS6 4HZ
Tel: 0113 216 1144
Fax: 0113 274 5886
E-mail: info@cgduk.com
 
     
Title  
Name  
School  
Address  
   
Town / City  
County  
Post Code  
Work Phone  
Fax  
E-mail  

         

No of staff to be insured (FTE only) Required Daily 
amount of cover
Required 
Excess Days

Teaching Staff

Other Staff

Other Staff

Claims experience
(Please advise the total number of days claimed in the last 3 years).

  Teaching Staff Other Staff Excess Days
2005/2006

2006/2007
2007/2008

  Please indicate if there are

(1) Any staff who are absent due to injury or illness at present time
(2) Any staff who are likely to be absent in future due to an existing injury or illness, including  any planned surgery.
(3) Any staff who have a medical history as a result of any stress or nervous relate illness Message

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