SAMPLE QUOTATION for INSURANCE/INVESTMENT PLAN
Hi! I'm Camille, a Licensed Financial Advisor from PruLife UK, helping young adult income earners with difficulty in making financial decisions gain clarity and progress through simplified systems. Kindly, fill out the necessary information to check the insurance/investment options for you. All the information you provide in this form will be used for the sample quotation and consultation purposes only. Rest assured that these will be treated with utmost confidentiality. For further guidance, kindly send me a message via messenger - m.me/camillaarchive . Thank you!
FULL NAME
*
NICKNAME
BIRTHDATE
*
/
Month
/
Day
Year
Date
SEX
*
Male
Female
CONTACT NUMBER
EMAIL ADDRESS
*
FACEBOOK PROFILE LINK
*
PRESENT ADDRESS (City and Province)
*
EMPLOYMENT STATUS
*
Corporate Employee
Freelance
OFW
Business Owner
Student
Unemployed
Other
OCCUPATION
NATURE OF WORK/BUSINESS
*
Accommodation and Food Services
Agriculture, Forestry, Fishing and Hunting
Arts, Entertainment, and Recreation
Construction
Educational Services
Finance and Insurance
Health Care and Social Assistance
Information
Manufacturing
Mining, Quarrying, and Oil and Gas Extraction
Other Services (except Public Administration)
Professional Services
Public Administration
Real Estate, Rental, and Leasing
Scientific and Technical Services
Transportation and Warehousing
Utilities
Wholesale and Retail Trade
ESTIMATED MONTHLY INCOME
*
Below Php 15,000
Php 15,000 to 20,000
Php 21,000 to 40,000
Php 41,000 to 80,000
Php 81,000 to 100,000
Above Php 100,000
WHAT'S THE MAIN PURPOSE FOR INQUIRING AND EXPLORING INSURANCE/INVESTMENT OPTIONS? (Choose all that apply)
*
Income protection in case something happens to me
Critical Illness Fund
Retirement Fund
Education Fund for my child/ren
Savings for Medium-term to Long-term goals
Other
HOW MUCH CAN YOU SAVE PER MONTH FOR YOUR PLAN?
*
Less than Php 1,000
Php 1,001 to Php 2,000
Php 2,001 to Php 3,000
Php 3,001 to Php 4,000
Php 4,001 to Php 5,000
Php 5,001 to Php 6,000
Php 6,001 to Php 7,000
Php 7,001 to Php 8,000
Php 8,001 to Php 9,000
Php 9,001 to Php 10,000
More than Php 10,000
Submit
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