Agent Referral Program

Refer an agent and earn $50!

Personal Info

Full Name: *

Phone Number: *

Email Address: *

Address: *

City: *

State: *

Zip Code: *

Referred Agents Info

Name of Agent: *

Phone Number: *

Email Address: *

Address:

City:

State:

Zip Code:

United Insurance Group
1150 Corporate Office Dr.
Suite 220 Milford, MI 48381

Phone: (800) 878-1058
Fax: (248) 676-0713
Email: [email protected]

Corporate website: www.uiginc.com
Career Division website: www.agentcareer.com