Risk Management Service

Short Term Travel Online Application Form

INSTRUCTIONS - Please Read
- Cover is not automatic on application.
- The SDA organisation paying for your travel cover will be contacted by RMS to seek their written approval before we can place cover.
- We seek this approval on the same, or next business day that we receive your request, but please note that we sometimes experience delays during this process.
- Therefore, do not leave your request for cover to the last minute - apply for cover as soon as you've made your first travel booking.
- Ensure the email addresses you provide are correct! Your certificate will be emailed to you.
- If you don’t hear from us within 3 business days please drop us a line.
- If you would like to read the Summary of Cover before you apply, please contact us and we will email it to you.
Our business hours are Monday to Thursday 8:30am to 5:00pm, and Fridays 8:30am to 12:00pm.
To request cover, please acknowledge you've read and understood this information by checking the box below, you will then be able to complete and submit the short term travel request form.
COVID Checkbox*
- I have read this important information
Purpose
What is the purpose of your travel?*
Applicant's Details
Title
First Name*
Last Name*
Date of Birth*
Reduced benefits may apply for travellers aged 75 or over. See Summary of Cover for details.
DD slash MM slash YYYY
Address*
Street Address Address Line 2 City / Suburb State / Province / Region ZIP / Postal Code
Country*
Country of residence
Email Address*
Home or Mobile Phone Number*
Work Phone Number*
Travel Details
Please allow 3 business days (Mon-Fri) for your request for cover to be processed.
Date travel commences*
DD slash MM slash YYYY
Date Traveller arrives home*
DD slash MM slash YYYY
Destination of Travel (Please indicate the country or city where you will spend the most time)*
Area of travel*
Billing Information
Adventist Organisation to be charged*
Reference for your accounts department eg. department, project, trip etc*
Email address of person at that organisation responsible for authorising your application & accepting the cost*
Today's Date*
Accept Privacy Policy*
- I have read and accept the RMS Privacy Policy.
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Short Term Travel Online Application Form

Short Term Travel Online Application Form

INSTRUCTIONS - Please Read

Purpose

Applicant's Details

Travel Details

Billing Information