Travel Insurance Application Form ~~~~~~~~~~~
This insurance is underwritten by: Blue Cross (Asia-Pacific) Insurance Limited
Please print out this form, fill in the required details, then fax to 852-25197296 Tiglion Travel Services Co. Ltd.
All insurance transactions must be
arranged within the territory of the Hong Kong Special Administrative Region.
Tiglion Travel Services Company Limited (Lic 350005) and (Insurance Agent Reg 95903303)
[ Insurance Agent for Blue Cross (Asia-Pacific) Insurance Limited ]
Rm 902 Yue Xiu Building, 160-174 Lockhart Road, Wanchai, Hong Kong
Tel 852-25117189   Fax 852-25197296
Email: firstname.lastname@example.org Website: http://www.travel.com.hk
Copyright (c) 1995 - Tiglion Consultancy Company Limited. All rights reserved.