Shipping Insurance Form-Greater Than $250K

Please fill out the following form to be covered under MIT's shipping insurance. Any questions please contact Sarah Brown.

1 General Info 2 Shipping Details 3 Preview Page 4 Complete

Department, Lab, Center (DLC) Contact Name *

Email *

Phone *

DLC Name *

Shipment Logistics *

Leaving MIT

Coming to MIT

Other

Shipping Company Name *

Shipping Company Contact *

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