Insurance

First Name *

Last Name *

Date of Birth (yyyy-mm-dd)*

Gender *

Phone Number *

E-mail Address *

Apartment Number

Street Address *

City *

Province *

Postal Code *

Arrival date in Canada (yyyy-mm-dd) *

Beneficiary Name (Father/Mother/Spouse/Child) *

Relation with Beneficiary *

Date of Birth of Beneficiary (yyyy-mm-dd) *

Mention Health Issue (if any)

Policy Start Date * (yyyy-mm-dd)

Policy End Date (yyyy-mm-dd)

Select Annual Berkley Coverage Plan

If you are choosing less than a year plan the price will get lower and will be charged as per the policy duration selected. For any query you can contact us

Berkley Standard Plan - $495 /year

Berkley Enhanced Plan - $595 /year

Berkley Premium Plan - $695 /year

Alliance Student Policy - $699 /year

Card Detail

Card Type *

Name on Card *

Credit Card No *

Expiry (mm/yyyy) *

CVV (3 digit code) *

Passport Number *

Attach Passport (JPG, PNG,PDF, Less than 2MB)

By clicking submit now, you are giving permission to the Education Station to use your provided information for insurance purposes. Your information will only be used by the company to provide you insurance.

+1 438-926-0006

+91 94636-45457

info@myedustation.com

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Insurance

Select Annual Berkley Coverage Plan

Card Detail