Referral Form

Refer a friend to Swift Kennedy & Associates

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

This referral applies only to Life and Health insurance.

Your Information

First Name*

Last Name*

Your Email Address*

Your Phone Number*

Your Friend's Information

Friend's First Name*

Friend's Last Name*

Your Friend's Email Address*

Your Friend's Phone Number*

Special Comments*

Submission Validation

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With offices located in:
DuBois - Corporate Office
State College Office
Scranton Office
Williamsport Office
Virginia Beach Office
Ph: 800.503.7750
Fx: 800.920.7992