Collingwood Short Term Learners

1. Vehicle Details

Manually select the vehicle

Make and Model

Vehicle Value

Date First Registered

Body Type As recorded on your V5 registration document

Is this a Company Car?

On a company car, it is the owner's responsibility to ensure that it is acceptable to have a separate learner driver insurance policy on the vehicle.

Please confirm that you acknowledge the above statement

Registered Keeper

If the vehicle being insured Does Not belong to the Provisional Licence holder, the registered keeper must have their own motor insurance policy in place for this vehicle and it must remain in force for the entire period of the Collingwood policy for cover to be deemed valid.

Please confirm that you acknowledge the above statements

Has the Car Been Modified? Please note, we do not cover cars with dual controls

2. About You

Title

First Name

Surname

Date of Birth

Telephone No.

Mobile No.

Yes No

UK Provisional Driving Licence Only. If you are a full licence holder from onset of cover, your policy will be declared void/cancelled, premium will be retained and claims will not be paid.

What is your employment status?

What is your main employment?

Which Industry do you work in?

Do you have a second employment?

3. Address Information

Post Code Enter Address Manually

Address

4. User Details

Username

Password

Confirm Password

Security Question

Security Answer

5. Declaration and Preferences

In order to provide our services we will collect and use personal data about you and anyone you provide personal data for. The legal foundation for processing this data is obtained on a contract basis, is for the performance of an insurance contract between you and your insurer.

We also collect other data from you to enable us as your insurance intermediary to provide our services; these include your mobile telephone number, email address, third party authority details, payment information including debit/credit card details and/or bank account number and sort code. We have a legitimate interest to collect this information from you in order to provide our services including administer your online account.

I understand that Collingwood Insurance Services (UK) Ltd (CISL) will process my personal data in order to provide a motor insurance quotation, and may also share my data with the Insurer Collingwood Insurance Company Limited (CISL) and other associated third parties should I subsequently make an application or purchase a policy, as per the Privacy Policy

I confirm I have read and accepted the CISL Privacy Policy and that I understand that CISL will process my data, and that of any authorised person's data, in accordance with the General Data Protection Regulation. I acknowledge that if I request to restrict or block the processing of this personal data that my policy may be cancelled.

Collingwood take the privacy of your data very seriously and only use your information for administering your account with us. However, from time to time, we may like to contact you with details of products, services and additional benefits that we can offer. By ticking this box, you consent to being contacted.

We would also like to pass your details, or those of your authorised onto selected marketing affiliates, who may contact you by email with details of associated products and services that they provide. By ticking this box, you consent to your details being forwarded.

Your Cover Includes
You Pick The Duration
28 Days to 24 Weeks (and 7 day top ups)
Insured For Driving Test
Insured For Lessons
Free Courtesy Car*
Claims Management Service
Third Party Liability
Accelerated No-Claims

*Dependent on level of cover chosen. T&C's apply

Short-Term Learner Driver Insurance

1. Vehicle Details

2. About You

3. Address Information

4. User Details

5. Declaration and Preferences

Specify Address