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CUSTOMER INFORMATION
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Enrolment open for Canadians ages 45 to 75
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By giving us your email address, you agree to allow the Direct Marketing division of Canada Life to contact you from time to time in relation to the products we offer, unless you tell us otherwise. Your information is collected, stored and used consistent with our Privacy Guidelines. If you have any questions please contact Canada Life at 140 Fullarton St. 10th floor, London, ON. N6A 5P2 or call 1-800-265-3449.
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Date of Birth
Enrolment open for Canadians ages 45 to 75
Gender
Have you used any tobacco products or nicotine substitutes within the past 12 months?
Premium Amount


The Canadian Tire Sure Life Insurance PlanTM is underwritten by The Canada Life Assurance Company under Group Policy No. 74631 issued to Canadian Tire Financial Services Limited. The information requested in the above section is required in order for The Canada Life Assurance Company to provide an accurate quote.