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Date Need Coverage
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Effective Date
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Liability Required
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Drone Damage Protection
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Were there any claims, injuries, or accidents in the past 10 years?
Yes
No
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Is applicant End User or Manufacturer
End User
OEM Device
Manufacturer
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Describe Operation Environment
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Service purposes please provide
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What date did you first start operating a drone?
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Have you received formal drone training?
Yes
No
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If yes, which training company did you use?
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If yes, which qualification did you receive?
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Have you passed a Ground School/Theory course?
Yes
No
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If yes, please specify the date:
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Have you passed a Flight Test?
Yes
No
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If yes, please specify the date
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Are you in possession of a "Permission to Fly" from your national aviation authority?
Yes
No
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Applicant Full Name
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Please type your full name.
Company Name (or Individual)
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Phone Number
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E-mail
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Address 1:
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Address 2:
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Postal Code:
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Website Address:
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