Refer A Friend We count ourselves very fortunate to have incredible clients like you and we’d like to have even more! Inspiring JOY in our CommUNITY We’re proud to announce our enhanced Referral Program! We’re excited to GIVE BACK by donating $100 DOLLARS per month for a TOTAL of $1200 to a local charities that you choose each month. For every referral you will get a $15 gift card plus be entered to choose the charity of the month! It’s simple too – just 3 Easy Steps! Tell your friends, family, and Co-workers about Johns Family Insurance – so they can be happy too! Inspire them to call 914-269-2334 or email firstname.lastname@example.org and mention Your Name when they get a quote for insurance. You win Great Prizes, We Give to our monthly charity, and Inspire Joy too! Remember, there’s no limit to the number of people you can REFER or the number of times your name can be entered to win! Multiple referrals = more chances for YOU to WIN = Making a difference in our local community! Tell others about Us and Help OUR Community! Client Referral Form Step 1 of 3 - Your Contact Info 33% Your Name (customer)* First Last Who are you referring to us?* First Last Their Phone Number*Their Email Do you know what they need a quote for?* Home / Condo / Renters Auto Life and/or Health Business Motorcycle / ATV Boat & Watercraft Select all that apply Comments or Questions?