Vstore by The Viriyah Insurance

Home / Subscription

Subscription

Welcome
to V-Store Subscription System

Please fill out all the required information completely and truthfully to be entitled to buy insurance online with V-Store - the online insurance service that offers you more than coverage.

Personal Detail

E-Mail*		Confirm E-mail*
First name*		Last name*
I.D Card No.*		Date of birth*
Age		Gender*
Marital status		Home phone number
Mobile phone number*		Confirm mobile phone number*
Fax number

Address

House number		Village No.
Building / Village		Lane / Alley
Street		City
District		Sub-district
Postcode

Please type security image*	Change security image
Term and Condition	I would like to buy an insurance policy from your company under the terms the company has set for this insurance policy. I warrant that the particulars provided above are correct and complete and agree that this request to buy insurance shall be the basis of the contract between the company and me. More

* Required Fields

x