Queensland Business Insurance

Ausure Coast & Country would like to Thank You for your referrals in the way of a gift card. For all referrals that are sent to us and become a client* of Ausure Coast and Country, we would like to reward you with a Gift voucher of your choice.

Policy Type		Voucher Value
Motor/Boat/Caravan Insurance		$10
Home & Contents Insurance		$25
Landlords Insurance		$25
Business Insurance		$50
Body Corporate Insurance		$50

Example: If you refer a friend who has two Motor Vehicles, Home & Contents and a Business and they choose to insure with Ausure Coast & Country you will receive $95.00 (2 x $10 + $25 + $50) worth of vouchers, once full payment for your referral’s policies is received.

*A client is someone who has an active and paid policy with Ausure Coast & Country. Gift Cards will be sent once the policy is paid for in full.

Your Details

Title DR MISS MR MRS MS

First Name *

Last Name *

Email Address *

Person you're Referring Details

Referral name or company name

Referral Suburb

Referral contact number or email address

Would they like Us to contact Them Yes, if yes are they aware of your referral to us Yes No No

Select the type of insurance you are referring Motor Insurance Home & Contents Insurance Landlords Insurance Body Corporate Insurance Business Insurance Other

Choose your preferred voucher Coles Myer Woolworths JB Hi Fi Other