ICBC Request Form

    Your Name *

    Phone Number

    Email *

    EXPIRY DATE

    POLICY TYPE

    Additional Information

    BY CLICKING THIS BOX, YOU ARE CONSENTING TO THUNDERBIRD INSURANCE ACCESSING YOUR ICBC ACCOUNT AND PROCESSING YOUR TRANSACTION OVER THE PHONE AS WELL AS CONSENTING TO RECEIVING YOUR PERSONAL INFORMATION, INSURANCE FORMS/DECALS AND, IF APPLICABLE, BANKING INFORMATION BY EMAIL AND/OR MAIL.
    I AGREE AND UNDERSTAND THAT MY ICBC INSURANCE IS NOT RENEWED AND MY COVERAGE WILL NOT TAKE EFFECT UNTIL A LICENSED INSURANCE ADVISOR HAS CONTACTED ME AND CONFIRMED AND INFORMED ME THAT MY INSURANCE POLICY HAS BEEN BOUND.