Submit a Referral

Know someone who would make a great agent? Your referral could earn you $2,500!

We’re looking for people who are hardworking, motivated to succeed and looking to make a difference. Sound like someone you know? Submit their contact information and you could earn a reward!

Your Information

Name

Address

Address Line 2

City

State

Zip Code

Email Address

Phone Number

Are you a Farm Bureau member?

Yes

You must be a Farm Bureau member to be eligible for the referral reward payment of $2,500. Connect with your local Farm Bureau for membership information.

Referral Information

Referral Name

Referral Email Address

Referral Phone Number

Referral State of Residence

Is this person aware that you are referring them?

Yes