Perks Program

One of the best compliments a client can give us is to refer a friend, family member, or business to our agency.  We want to reward our clients for their referrals, and have come up with a program to do just that.

Join our Perks Program, and for every referral that becomes a Mid-State Insurance customer, you will receive a $10 Starbucks gift card!  For every 3 referrals we receive, you will be entered into a grand prize drawing at the end of the year!  The more referrals you send, the better your chances to win!

Refer a Friend

Referral's Name:
Referral's Address:
Referral's E-mail:
Referral's Phone:
Referred by (Your Name):
Your E-mail:
If my referral becomes a Mid-State customer, I would like a $10 gift card to: