Halloween Candy Jar Contest
Winner will be announced on October 27th. Residents of IL & IN only. Limit one entry per household.
How many pieces of candy are in this jar?
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Name
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First Name
Last Name
Your Age (21+ only)
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This contest includes an alcoholic prize
Cell Phone Number
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We will text confirmation and contact you at this number if you are a winner!
Address (prize may be shipped here)
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Street Address
Street Address Line 2
City
State
Zip Code
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We would love the opportunity to earn your business! Would you be willing to have a conversation about your insurance?
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Yes, please! (2 extra guesses AND a hint)
No, thank you.
Current Client (2 extra guesses AND a hint for VERIFIED clients)
HINT: There are 400-500 pieces of candy in this jar.
Extra guess #1
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Extra guess #2
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Do you own or rent your home?
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Own
Rent
Other
How old is your roof?
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Do you have any vehicles?
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Yes, I have vehicles.
No, I do not have any vehicles.
How many drivers are on your current policy?
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How many vehicles are on your current policy?
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Please list vehicle year/make/model(s), driver names and birthdays, and any other info we'd need to quote your auto policy (tickets, accidents, SR22, etc).
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Are you interested in any other insurance quotes? You can include details here.
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LAST PAGE!
We will send you a text shortly asking for a copy or screenshots of your current coverages. If you send those to us, we create a side-by-side chart like the one above.
Submit
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