goldstar-payments.tafari.digital Open in urlscan Pro
206.81.31.35  Public Scan

Form analysis
3 forms found in the DOM

<form _ngcontent-ng-c3247293369="" novalidate="" class="ng-untouched ng-pristine ng-invalid"><!---->
  <div _ngcontent-ng-c3247293369="" class="flex justify-center">
    <div _ngcontent-ng-c3247293369="" class="w-fit"><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-date-range-input mat-mdc-form-field-has-icon-suffix mat-form-field-appearance-outline mat-primary ng-tns-c1534922977-1"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--notched mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch" style="width: calc(146px * var(--mat-mdc-form-field-floating-label-scale, 0.75) + 9px);"><label matformfieldfloatinglabel=""
                  class="mdc-floating-label mat-mdc-floating-label mdc-floating-label--float-above" id="mat-mdc-form-field-label-0" style=""><mat-label _ngcontent-ng-c3247293369="">Enter a date range</mat-label><span aria-hidden="true"
                    class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><mat-date-range-input _ngcontent-ng-c3247293369="" role="group"
                class="mat-date-range-input mat-mdc-input-element mat-mdc-form-field-input-control mdc-text-field__input mat-date-range-input-hide-placeholders mat-date-range-input-required" id="mat-date-range-input-0"
                aria-labelledby="mat-mdc-form-field-label-0" data-mat-calendar="mat-datepicker-0">
                <div cdkmonitorsubtreefocus="" class="mat-date-range-input-container">
                  <div class="mat-date-range-input-wrapper"><input _ngcontent-ng-c3247293369="" type="text" formcontrolname="start" matstartdate="" placeholder="Start date"
                      class="mat-start-date mat-date-range-input-inner ng-untouched ng-pristine ng-valid" aria-haspopup="dialog"><span aria-hidden="true" class="mat-date-range-input-mirror">6/20/2024</span></div><span
                    class="mat-date-range-input-separator">–</span>
                  <div class="mat-date-range-input-wrapper mat-date-range-input-end-wrapper"><input _ngcontent-ng-c3247293369="" type="text" formcontrolname="end" matenddate="" placeholder="End date"
                      class="mat-end-date mat-date-range-input-inner ng-untouched ng-pristine ng-valid" aria-haspopup="dialog"><span aria-hidden="true" class="mat-date-range-input-mirror">6/20/2024</span></div>
                </div>
              </mat-date-range-input><mat-date-range-picker _ngcontent-ng-c3247293369="" disabled="false"></mat-date-range-picker><!----></div><!---->
            <div class="mat-mdc-form-field-icon-suffix"><mat-datepicker-toggle _ngcontent-ng-c3247293369="" maticonsuffix="" class="mat-datepicker-toggle" data-mat-calendar="mat-datepicker-0"><button mat-icon-button="" type="button"
                  mat-ripple-loader-uninitialized="" mat-ripple-loader-class-name="mat-mdc-button-ripple" class="mdc-icon-button mat-mdc-icon-button mat-unthemed mat-mdc-button-base" mat-ripple-loader-centered="" aria-haspopup="dialog"
                  aria-label="Open calendar" tabindex="0"><span class="mat-mdc-button-persistent-ripple mdc-icon-button__ripple"></span><svg viewBox="0 0 24 24" width="24px" height="24px" fill="currentColor" focusable="false" aria-hidden="true"
                    class="mat-datepicker-toggle-default-icon">
                    <path d="M19 3h-1V1h-2v2H8V1H6v2H5c-1.11 0-1.99.9-1.99 2L3 19c0 1.1.89 2 2 2h14c1.1 0 2-.9 2-2V5c0-1.1-.9-2-2-2zm0 16H5V8h14v11zM7 10h5v5H7z"></path>
                  </svg><!----><span class="mat-mdc-focus-indicator"></span><span class="mat-mdc-button-touch-target"></span></button></mat-datepicker-toggle></div><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field></div>
  </div>
  <div _ngcontent-ng-c3247293369="" class="flex justify-center my-5">
    <div _ngcontent-ng-c3247293369="" class="flex flex-col space-y-4 w-full md:w-1/2"><label _ngcontent-ng-c3247293369="" id="example-radio-group-label">Choose a Travel Insurance Package</label><mat-radio-group _ngcontent-ng-c3247293369=""
        role="radiogroup" color="primary" aria-labelledby="example-radio-group-label" formcontrolname="selectedRegion" class="mat-mdc-radio-group example-radio-group ng-untouched ng-pristine ng-valid"><mat-radio-button _ngcontent-ng-c3247293369=""
          class="mat-mdc-radio-button example-radio-button mat-primary" id="mat-radio-2">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-2-input" name="mat-radio-group-0" value="WORLDWIDE BASIC" tabindex="-1">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-2-input">WORLDWIDE BASIC</label>
          </div>
        </mat-radio-button><mat-radio-button _ngcontent-ng-c3247293369="" class="mat-mdc-radio-button example-radio-button mat-primary" id="mat-radio-3">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-3-input" name="mat-radio-group-0" value="STUDENTS CLASSIC" tabindex="-1">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-3-input">STUDENTS CLASSIC</label>
          </div>
        </mat-radio-button><mat-radio-button _ngcontent-ng-c3247293369="" class="mat-mdc-radio-button example-radio-button mat-primary" id="mat-radio-4">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-4-input" name="mat-radio-group-0" value="WORLDWIDE GOLD" tabindex="-1">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-4-input">WORLDWIDE GOLD</label>
          </div>
        </mat-radio-button><mat-radio-button _ngcontent-ng-c3247293369="" class="mat-mdc-radio-button example-radio-button mat-primary" id="mat-radio-5">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-5-input" name="mat-radio-group-0" value="ASIA" tabindex="-1">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-5-input">ASIA</label>
          </div>
        </mat-radio-button><mat-radio-button _ngcontent-ng-c3247293369="" class="mat-mdc-radio-button example-radio-button mat-primary mat-mdc-radio-checked" id="mat-radio-6">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-6-input" name="mat-radio-group-0" value="AFRICA" tabindex="0">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-6-input">AFRICA</label>
          </div>
        </mat-radio-button><mat-radio-button _ngcontent-ng-c3247293369="" class="mat-mdc-radio-button example-radio-button mat-primary" id="mat-radio-7">
          <div mat-internal-form-field="" class="mdc-form-field mat-internal-form-field">
            <div class="mdc-radio">
              <div class="mat-mdc-radio-touch-target"></div><input type="radio" class="mdc-radio__native-control" id="mat-radio-7-input" name="mat-radio-group-0" value="EUROPE BASIC" tabindex="-1">
              <div class="mdc-radio__background">
                <div class="mdc-radio__outer-circle"></div>
                <div class="mdc-radio__inner-circle"></div>
              </div>
              <div mat-ripple="" class="mat-ripple mat-radio-ripple mat-mdc-focus-indicator">
                <div class="mat-ripple-element mat-radio-persistent-ripple"></div>
              </div>
            </div><label class="mdc-label" for="mat-radio-7-input">EUROPE BASIC</label>
          </div>
        </mat-radio-button><!----></mat-radio-group></div>
  </div>
  <div _ngcontent-ng-c3247293369="" class="flex justify-center">
    <div _ngcontent-ng-c3247293369="" class="grid sm:grid-cols-1 md:grid-cols-2 gap-5 w-full lg:w-3/4"><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-primary ng-untouched ng-pristine ng-tns-c1534922977-2 ng-valid"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--upgraded mdc-notched-outline--notched">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch" style="width: calc(167px * var(--mat-mdc-form-field-floating-label-scale, 0.75) + 9px);"><label matformfieldfloatinglabel=""
                  class="mdc-floating-label mat-mdc-floating-label mdc-floating-label--float-above" id="mat-mdc-form-field-label-2" for="mat-input-0" style=""><mat-label _ngcontent-ng-c3247293369="">Destination Country&lt;</mat-label><span
                    aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" type="text" matinput="" formcontrolname="selectedCountry"
                class="mat-mdc-input-element mat-mdc-autocomplete-trigger ng-untouched ng-pristine mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored ng-valid" id="mat-input-0" required="" aria-required="true"
                autocomplete="off" role="combobox" aria-autocomplete="list" aria-expanded="false" aria-haspopup="listbox" aria-invalid="false"><!----><mat-autocomplete _ngcontent-ng-c3247293369="" autoactivefirstoption=""
                class="mat-mdc-autocomplete ng-tns-c3964489799-3"><!----></mat-autocomplete></div><!----><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-primary ng-untouched ng-pristine ng-valid ng-tns-c1534922977-4"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--notched mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch" style="width: calc(166px * var(--mat-mdc-form-field-floating-label-scale, 0.75) + 9px);"><label matformfieldfloatinglabel=""
                  class="mdc-floating-label mat-mdc-floating-label mdc-floating-label--float-above" id="mat-mdc-form-field-label-4" for="mat-input-1" style=""><mat-label _ngcontent-ng-c3247293369="">Number of Travellers</mat-label><span
                    aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" matinput="" formcontrolname="numberOfTravelers" type="number" placeholder="Number of travellers" required=""
                class="mat-mdc-input-element w-full ng-untouched ng-pristine ng-valid mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored" id="mat-input-1" aria-invalid="false" aria-required="true"></div>
            <!----><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field></div>
  </div>
  <div _ngcontent-ng-c3247293369="" class="flex justify-center">
    <div _ngcontent-ng-c3247293369="" class="grid sm:grid-cols-1 md:grid-cols-2 gap-5 w-full lg:w-3/4"><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-hide-placeholder mat-primary ng-untouched ng-pristine ng-invalid ng-tns-c1534922977-5"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch"><label matformfieldfloatinglabel="" class="mdc-floating-label mat-mdc-floating-label" id="mat-mdc-form-field-label-6" for="mat-input-2" style=""><mat-label _ngcontent-ng-c3247293369="">Full
                    Name/Company Name</mat-label><span aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" matinput="" formcontrolname="name" placeholder="Your Full Name or Company Name" required=""
                class="mat-mdc-input-element w-full ng-untouched ng-pristine ng-invalid mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored" id="mat-input-2" aria-required="true"></div><!----><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-hide-placeholder mat-primary ng-untouched ng-pristine ng-invalid ng-tns-c1534922977-6"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch"><label matformfieldfloatinglabel="" class="mdc-floating-label mat-mdc-floating-label" id="mat-mdc-form-field-label-8" for="mat-input-3" style=""><mat-label _ngcontent-ng-c3247293369="">Agent
                    Code</mat-label><span aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" matinput="" formcontrolname="code" placeholder="Agent code" required=""
                class="mat-mdc-input-element w-full ng-untouched ng-pristine ng-invalid mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored" id="mat-input-3" aria-required="true"></div><!----><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field></div>
  </div>
  <div _ngcontent-ng-c3247293369="" class="flex justify-center">
    <div _ngcontent-ng-c3247293369="" class="grid sm:grid-cols-1 md:grid-cols-2 gap-5 w-full lg:w-3/4"><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-hide-placeholder mat-primary ng-untouched ng-pristine ng-invalid ng-tns-c1534922977-7"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch"><label matformfieldfloatinglabel="" class="mdc-floating-label mat-mdc-floating-label" id="mat-mdc-form-field-label-10" for="mat-input-4" style=""><mat-label
                    _ngcontent-ng-c3247293369="">Phone</mat-label><span aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" matinput="" formcontrolname="phone" placeholder="Phone number" required=""
                class="mat-mdc-input-element w-full ng-untouched ng-pristine ng-invalid mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored" id="mat-input-4" aria-required="true"></div><!----><!---->
          </div><!---->
        </div>
        <div class="mat-mdc-form-field-subscript-wrapper mat-mdc-form-field-bottom-align"><!---->
          <div class="mat-mdc-form-field-hint-wrapper ng-trigger ng-trigger-transitionMessages" style="opacity: 1; transform: translateY(0%);"><!---->
            <div class="mat-mdc-form-field-hint-spacer"></div>
          </div><!---->
        </div>
      </mat-form-field><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
        class="mat-mdc-form-field mat-mdc-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-hide-placeholder mat-primary ng-untouched ng-pristine ng-invalid ng-tns-c1534922977-8"><!---->
        <div class="mat-mdc-text-field-wrapper mdc-text-field mdc-text-field--outlined"><!---->
          <div class="mat-mdc-form-field-flex">
            <div matformfieldnotchedoutline="" class="mdc-notched-outline mdc-notched-outline--upgraded">
              <div class="mdc-notched-outline__leading"></div>
              <div class="mdc-notched-outline__notch"><label matformfieldfloatinglabel="" class="mdc-floating-label mat-mdc-floating-label" id="mat-mdc-form-field-label-12" for="mat-input-5" style=""><mat-label
                    _ngcontent-ng-c3247293369="">Email</mat-label><span aria-hidden="true" class="mat-mdc-form-field-required-marker mdc-floating-label--required"></span><!----></label><!----><!----><!----></div>
              <div class="mdc-notched-outline__trailing"></div>
            </div><!----><!----><!---->
            <div class="mat-mdc-form-field-infix"><!----><input _ngcontent-ng-c3247293369="" matinput="" formcontrolname="email" placeholder="Email address" required=""
                class="mat-mdc-input-element w-full ng-untouched ng-pristine ng-invalid mat-mdc-form-field-input-control mdc-text-field__input cdk-text-field-autofill-monitored" id="mat-input-5" aria-required="true"></div><!----><!---->
          </div><!---->
        </div>
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        <div class="mdc-checkbox">
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        mat-ripple-loader-uninitialized="" mat-ripple-loader-class-name="mat-mdc-button-ripple" type="submit"><span class="mat-mdc-button-persistent-ripple mdc-fab__ripple"></span><mat-icon _ngcontent-ng-c3247293369="" role="img"
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<form _ngcontent-ng-c3247293369="" novalidate="" class="ng-untouched ng-pristine ng-valid"><small _ngcontent-ng-c3247293369="">Policy Holder - Must be 18 years above at the time of Travel.</small><!---->
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        class="mat-icon notranslate material-icons mat-ligature-font mat-icon-no-color" aria-hidden="true" data-mat-icon-type="font">arrow_right_alt</mat-icon><span class="mdc-button__label">Next</span><span
        class="mat-mdc-focus-indicator"></span><span class="mat-mdc-button-touch-target"></span></button></div>
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<form _ngcontent-ng-c3247293369="" novalidate="" class="ng-untouched ng-pristine ng-invalid"><!----><mat-form-field _ngcontent-ng-c3247293369="" appearance="outline"
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</form>

Text Content

1
Trip Details


2
Travellers


3
make Payment


4
Confirmation
Enter a date range

6/20/2024
–
6/20/2024


Choose a Travel Insurance Package

WORLDWIDE BASIC

STUDENTS CLASSIC

WORLDWIDE GOLD

ASIA

AFRICA

EUROPE BASIC
Destination Country<



Number of Travellers



Full Name/Company Name



Agent Code



Phone



Email




I agree to Goldstar terms and conditions.


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TRIPS DETAILS

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Name:

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Email:

--------------------------------------------------------------------------------

Phone:

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Package: AFRICA

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Trips date: Jun 20, 2024 - Jun 20, 2024

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Destination(s): ALGERIA

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Traveller(s): 1

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Policy Holder - Must be 18 years above at the time of Travel.

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ABOUT

--------------------------------------------------------------------------------

 * Who are we
 * Executive Committee
 * Company Responsibilities
 * Salvages

POLICY SERVICE

--------------------------------------------------------------------------------

 * Claims Philosophy
 * Online Billing & Payments
 * Policy Change Request
 * Terms & Conditions

LOCATION

--------------------------------------------------------------------------------

 * Plot 38 Kampala Road, Crane Chambers, Kampala

 * +256 41 4250110
 * goldstar@goldstarinsurance.com

--------------------------------------------------------------------------------

© 2018 Goldstar Insurance Limited™. All Rights Reserved.
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