Shelter Bay Financial
#211 – 3823 Henning Drive Burnaby, BC V5C 6P3
Phone: (604)832-2029 Fax: (604)287-2020
Your Name: (required) Your Email: (required) Subject: Message:
Type of Insurance: Life InsuranceDisability ProtectionCritical IllnessLong Term CareKey Person CoverageShareholder Insurance Amount of Insurance: Not sure$250,000$500,000$1,000,000$2,000,000 Date of Birth:*(yyyy-mm-dd) Marital Status? SingleMarriedCommon-LawWidowed Do you smoke?* NoYes Postal Code: Name:* Email:* Phone Number:*
