Online Application FormPart 1 | Contact DetailsSchool Name*School Address*School Postcode*School Type*PrimarySecondaryContact Name*Contact Position*Contact Email*Contact Number*Best time to contactPlease select the best time(s) for us to contact you. Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PMPart 2 | Benefit & Cover DetailsPlease give the details of the level of cover you require.Teacher FTE*Teacher Daily Benefit*Teacher Excess Days*Staff Support FTE*Staff Support Daily benefit*Staff Support Excess Days*Admin / Other FTE*Admin / Other Daily Benefit*Admin / Other Excess Days*Caretaker FTE*Caretaker Daily Benefit*Caretaker Excess Days*Would you like to include maternity cover?*YesNoHow much stress cover would you like to include?*No Cover30 DaysFull CoverPart 3 | 24 Months Absence DisclosurePlease give an overview of the absences that have taken place in the last 2 years. Please provide the details of absences during your insurance policy between 2016 to 2017Date* ToDate* Teachers Total Days of Absence*Teachers Total Cases of Absence*Staff Support Total Days of Absence*Staff Support Total Cases of Absence*Admin / Other Total Days of Absence*Admin / Other Total Cases of Absence*Caretaker Total Days of Absence*Caretaker Total Cases of Absence* Please provide the details of absences during your insurance policy between 2017 to 2018Date* ToDate* Teachers Total Days of Absence*Teachers Total Cases of Absence*Staff Support Total Days of Absence*Support Staff Total Cases of Absence*Admin / Other Total Days of Absence*Admin / Other Total Cases of Absence*Caretaker Total Days of Absence*Caretaker Total Cases of Absence*Part 4 | Medical AbsencePlease provide details of medical conditions leading to absence which exceeded your staff absence insurance excess in the previous 24 months minimum. The insurers prefer as much detail as possible to be able to provide the best premium, so please give as much history as you can.RepeaterStaff Member's CategoryStaff Member's FTEAbsence Start Date Absence End Date Cause of AbsenceStill EmployedYesNo Add another absencePart 5 | Ofsted ReportsDate of Last Inspection* Date of Next Inspection* Last Inspection Rating*Part 6 | Renewal DetailsCurrent Insurer*Renewal Price*Renewal Date* Part 7 | Additional DocumentsPlease upload any further documents to complete your application.To complete your application we need a copy of the following: 1. Full list of staff, including their position 2. A list of any additional absences 3. The latest Ofsted report from your most recent inspection 4. A complete school holiday list for your schoolIf you are unable to upload them now then send them in a separate email to email@example.com. Please bear in mind we are unable to offer a quotation until we have all of these documents. Drop files here or Terms and Conditions* Please tick the box to confirm you agree with the terms and condtions, and that all the information you have provided is accurate to the best of your knowledge. We will use the details you provide to contact you regarding this enquiry only. If you would like to receive further emails about other products, services or offers then please tick the box. Your details will not be shared or sold, and you can opt out at any time.