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Referral Form

Refer a friend to American Insurance Strategies


We love referrals! The greatest testament that our customers can provide is by referring their friends and family to American Insurance Strategies.
To show appreciation for your referral, we will donate $10 to one of the following charities you choose below:

- Make-A-Wish
- Wounded Warrior Project
- New Life Clinic
- Trim Hunger


Please indicate your choice of charity in Special Comments section below.  Thank you for your continued business! 

Your Information
First Name
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Last Name
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Your E-Mail Address
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Your Phone Number
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Your Friend's Information
Friend's First Name
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Friend's Last Name
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Your Friend's E-Mail Address
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Your Friend's Phone Number
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Special Comments
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