Homeowners Survey Giveaway

Just take a minute to complete our survey and you are automatically entered for a chance to win an iPhone 3G.

All fields Required

1) I shop my home insurance rates:	Please select Every 6 Months Once a year Once every few years
2) I shop my auto insurance rates:	Please select Every 6 Months Once a year Once every few years
3) When shopping for home insurance, the most important thing to me is:	Please select Affordable Rates The reputation of the provider The level of customer service and claims processing
4) I have the following security/safety features in my home:	Smoke alarms Burglar alarm Deadbolt locks
5) I rate my current auto insurance company’s level of customer service as:	Please select Good Great Superior Excellent
6) When shopping for auto insurance, the most important thing to me is:	Please select> Affordable Rates The reputation of the provider The level of customer service and claims processing
7) I am currently insuring both my home and my car(s) with the same insurance company:	Please select True False
8) When it comes to flood insurance,	Please select I carry flood insurance because I am required by my lender I do not carry flood insurance I carry flood insurance because I think it is valuable and it is not required by my lender
9) I am completely confident that the coverage limits on my home are high enough to replace my home and belongings to present condition.	Please select True False
10) When it comes to shopping for home and/or auto insurance, I prefer:	Please select Shopping online Speaking with a licensed agent over the phone Meeting with a licensed agent in person

Enter to Win!

Your specific answers to the questions above will remain confidential. However, please provide us with your contact information if you would like to be entered in the sweepstakes to win an iPhone

First Name:
Last Name:
Email:
Phone Number:
Mailing Address:
City:
State:	Choose your state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia
Zip Code:
Would you like a licensed insurance consultant to contact you for a Free Savings Review? (We save our customers $556/year on average)	Please select Yes No

The purpose of our customer survey is to learn about your needs and preferences as a homeowner and driver so that we can continue to improve our products and services to best suit your needs. Most people can fill out our survey in one minute or less- but don’t worry, we’re not timing you. We collect your contact information at the end of the survey so that you can be entered to win an iPhone.

HomeInsurance.com iPhone Giveaway

• The Contest will run from November 3-January 5th
• Participants may enter by successfully completing the HomeInsurance.com Survey above
• Eligible contestants must enter all contact information
• The winner will be drawn randomly from the pool of contestants by a HomeInsurance.com employee
• HomeInsurance.com Employees and their families are ineligible to win the contest
• The winner will be announced on Twitter and our home page on January 6th so Stay Tuned!
• The prize will be awarded within 30 days from the Contest End Date