Referrals

We’re working to grow our business!

If you have a friend, coworker or contact that you think could currently benefit from our courses, please fill out the form below. You can choose not to have us mention your name when we contact your referral but it really helps if we can.

Extra credit for students who refer their Licensing Supervisor/Trainer! These folks really help us spread the word about our courses.

Each time you refer someone we’ll buy you a cup of coffee* and you’ll be entered in our drawing for a $100 Amazon gift card, Starbucks gift card or $100 refund back to your course purchase (your choice).

Thank you for your support!

~ Jack & Nancy

Your Name:*

What state do you live in?*

Your Email:*

Name of Person You are Referring to AP:*

What state do they live in?*

Company (if applicable) of Person Being Referred:

Email of Person Being Referred:*

Phone Number of Person Being Referred:

How do you know this person?

Which best describes what this person does in the insurance industry?

Comments:

* designates a required field

*Students who submit new referrals, and allow us to mention them when we contact their referral, will be issued a $5 Starbucks gift card at the end of the month. Referrals must be actively considering an insurance license.