Term Life Insurance Application 

Life Insured

Coverage Selected

Min: 100,000 Max: 2,000,000


Existing Coverage

Note: Answer 'No' if you are replacing your bank owned mortgage life insurance. Only answer 'Yes' if you are replacing a life insurance policy that you own yourself.

*Never cancel or modify existing life insurance coverage until your new policy is fully in force

Medical History Call 

The Term Guy is a licensed life insurance agency serving residents of Ontario (Lic #37992M), British Columbia (Lic. #LIC-2021-0030559-R02), and Alberta (Lic. #5-11247944-2021).