Refer a Friend!

For every friend or family member that you refer to our agency, we will instantly send you a $50 Visa gift card if they start a new policy with us!*

So please have them call us at 800-875-8712 (make sure they mention your name) or fill out this form for them!

Let us help make insurance FAST, EASY and AFFORDABLE for your friends too!

* This offer is only available to clients of the Dan Kitajima Insurance Agency.

    Your Information

    Your Name

    Your Email

    Your Friend's Information

    Friend's Name

    Friend's Email

    Friend's Phone

    Your Agent (Optional)