Kelly Agency Referral Program

Refer a Friend, Support a Cause

Please enable JavaScript in your browser to complete this form.

Help us grow The Kelly Agency and we’ll donate to the charity of your choice.

Know someone looking for better insurance? Introduce us! If they complete a quote with our team, we’ll reward you and donate to a cause you care about. As a thank you, we offer two ways to reward you:

1. The Win-Win: We send you a $20 Gift Card and donate $20 to one of our 5 partner charities.
2. The Big Give: You waive your gift card, and we donate the full $40 to the charity.

Simply fill out the form below to get started.

The Person You Are Referring

Their Name *

First

Last

Their Phone Number *

Their Email (optional)

Notes / How can we help them? (optional)

Who at our agency should we connect them with? *— Select Choice —First Available AgentAshley NordlundChristina SaavedraColleen SnyderDaniela RodriguezDebbie SelmanGigi Cespedes PenaJose ChavezKevin KellyKrystal EvansLeah RavenLori AdamsMichelle NguyenNicole KarpinskiOlivia DeeringRoth GaglianoVictoria Cooper

Your Reward (Pick your path)

Select Your reward Preference *

• The Win-Win: Send me a $20 Gift Card + Donate $20 to Charity
• The Big Give: Donate the full $40 to Charity (No Gift Card for me)

Choose the Charity *

• Autism Speaks
• Breast Cancer Foundation
• KIND: Kids In Need of Defense
• Ronald McDonald House
• Wounded Warrier

Your Information (So we can thank you!)

Your Name *

First

Last

Your Email (Required for the gift card)

Your Phone Number

Submit Referral

Submit

Charity Details

🧩 Autism Speaks Dedicated to creating an inclusive world for all individuals with autism throughout their lifespan. They champion understanding, acceptance, and early intervention to help people on the spectrum reach their full potential. 🔗 Visit Website

🎀 Susan G. Komen Breast Cancer Foundation Standing with the fighters, the survivors, and the families affected by this disease. Their work focuses on providing help for today and hope for tomorrow through early detection, education, and support services. 🔗 Visit Website

⚖️ Kids in Need of Defense (KIND) Ensuring no child has to face immigration court alone. KIND provides high-quality legal protection and social services to unaccompanied refugee and immigrant children, advocating for their safety and rights. 🔗 Visit Website

🏠 Ronald McDonald House Providing a “home away from home” for families with sick children. They keep families together and near the medical care they need, removing the burden of housing costs during a medical crisis. 🔗 Visit Website

❤️‍🩹 Wounded Warrior Project Honoring and empowering our nation’s injured veterans. They provide life-changing programs in mental health, physical wellness, and career counseling to help our warriors recover and thrive. 🔗 Visit Website