Current SECTION A: FIRST LIFE INSURED/POLICYHOLDER SECTION B: NEXT OF KIN SECTION C: SECONDARY LIFE, IF OTHER THAN LIFE ASSURED SECTION D: INSURANCE STATUS SECTION E: BENEFICIARY(IES) SECTION F: METHOD OF PAYMENT SECTION G: DECLARATION SECTION H: INTERMEDIARY DETAILS Complete 1 of 9 Please insure that you fill in all the required fields in the below formSECTION A: FIRST LIFE INSURED/POLICYHOLDER FirstNames Surname Client Number Title Maiden Name and/ or former Surname Marital Status - None -SingleMarriedDivorcedWidowed Residential Address Date of Birth Postal Address Gender - None -MaleFemale Current Employer Cell Occupation Res Omang/Passport Number Work Monthly Income Email Smoker - None -YesNo Level of Education Do you have an existing policy with Botswana Life? - None -YesNo CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Follow us