Referral Form

Refer a friend to Stahlka Agency

We love referrals! The greatest testament that our customers can provide is by referring their friends and family to Stahlka Agency. Thank you for your referral, and we thank you even more for your continued business.

Your Information
First Name
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Last Name
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Your E-Mail Address
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Your Phone Number
Required
Your Friend's Information
Friend's First Name
Required
Friend's Last Name
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Your Friend's E-Mail Address
Required
Your Friend's Phone Number
Required
Special Comments
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Submission Validation
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For the safety of our staff
we are closing our offices for today Wednesday, January 30th.

Carrier numbers are available here our website or in an emergency you can reach our managers on their cell phones 
Fraser - Commercial Lines 716-510-8628
Jenn - Personal Lines 716-861-1328
Brad - Employee Benefits 716-465-7071
Stay Safe

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