Drain Protection UK Customer Registration Form

1
What type of Property Owner are you?* This field is required.
Bill Paying Tennant
Homeowner
Landlord
2
What type of Cover are you looking for?* This field is required.
Plumbing & Drainage
Boiler & Heating
Kitchen Appliance
Electrical
Gutter & Roofing
3
Policy Holder Full Name* This field is required.
First Name
Last Name
4
Policy Holder Email* This field is required.
So that we can send you the new temporary proof of insurance
5
Policy Holder Phone Number* This field is required.
6
Policy Holders Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Who Lives at the Property Day to Day?* This field is required.
Homeowner
Tennant
Landlord Tennant
8
Do you have Home Emergency Cover At The Moment?
YESNO
9
If Yes would you like free advice on cancelling your old Plan?We will call you prior to setting up you new Home Emergency Cover Plan with us.
YESNO
10
When would you like your Cover to start?* This field is required.
Date
Day
Month
Year
11
Add-a-Car ID #
12
Your Pricing Quote. (Next Choose Your Plan).Plan Pricing changes Periodically.
13
Choose Your Cover Plan.* This field is required.To Pay Yearly Please contact us directly: 0800 689 1862. Lines Open 24/7.
Plan 1.(Basic) Comprehensive Plumbing & Drainage Cover. £6.99 Per Month.
Plan 2. (Comprehensive) Boiler & Heating Cover. £10.99 Per Month.
Plan 3. (Recommended). Comprehensive Home Cover Plan. £21.99 Per Month
I am also a Landlord. £60 Additional Fee with any chosen Plan. Free Gas Safety Certificate provided every 12 Month's
Add On Plan. Comprehensive Kitchen Appliance Cover. £3 Per Month.
Add On Plan. Comprehensive Kitchen Appliance Cover. £3 Per Month.
Add On Plan. Comprehensive Kitchen Appliance Cover. £3 Per Month.
14
Bank Name
15
Policy Holder Name
16
Chosen Regular Payment Date* This field is required.
Date
Day
Month
Year
17
Account Number* This field is required.
Bank Account Number
18
Sort Code* This field is required.
Branch Code
19
I confirm I am happy for Drain Protection UK to send my Full Policy Documents in the Post, including Payment Schedule.* This field is required.
YESNO
20
Signature* This field is required.
Clear
21
22
Please look out for our Policy Documentation. This should arrive in the Post within the next 3-5 Working Day's.

Your cover starts from Today's date.

Your Preffered Payment Date will be your first Date of payment to us. If for any reason there is a problem with this Date we will contact you directly.

Thank you for choosing Drain Protection UK!

If you have any immidiate enquiries in relation to your Policy please contact us Directly using the Ref: DPUK54783. (0800 689 8162).Please also have your Post Code to hand.
23
Please rate your Sign Up experience today
24
Entitled to 30 Day's Free Cover?Enter your referral Link Below:
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