Broadbench Test Broadbench Test – Relevant Life First Name*Surname*Email* Phone*Date of Birth* DD MM YYYY Are you a smoker?*YesNoDo you have a limited company?*YesNoHow much cover do you need? (£)What is your contract rate / income? (£)Further details / your questionsWhen you click ‘send’, your data will be securely sent to the Broadbench relevant life insurance team, who will get back to you within 24 hours (Monday-Friday). We will not use your details for any other purpose. CommentsThis field is for validation purposes and should be left unchanged.