Refer Someone to Lang Insurance

Referral Program

Lang Insurance

Refer a Friend, Family Member, Neighbor or Co-worker to Lang Insurance to receive a $25 Gift Card!

One $25.00 card per referral once their insurance policy becomes effective. Not required to be a current Lang Insurance policy holder to participate in Lang Insurance Referral Program.

Simply complete the form below.

Your Information

First & Last Name ✶

Email ✶

Phone ✶

Referral Information

First & Last Name ✶

Relationship to You ✶

Email ✶

Phone ✶

Street Address

City

State

ZIP Code

Anything Else?

Comments

Binding Agreement

I understand that insurance coverage is not bound or altered until I receive confirmation by an authorized representative of Lang Insurance ✶

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