Squirrel Mortgages referral form Please complete the below form to submit an insurance referral to Tower. If you require assistance call us on 0508 278 683. * Required fields Business partner detailsOriginator detailsThis field is hidden when viewing the formName*Originator*Originator Email* Full name* First Last Email* Customer detailsFull name* TitleMrMrsMsMissDameDrLadyProfRevSir Prefix First Last Email* Contact phone number*Alternative contact phone numberCommentsWhat insurance would you like a quote for? (You can select more than one insurance)* Car insurance House insurance Contents insurance Boat insurance Landlord insurance What insurance would you like a quote for? (You can select more than one insurance)* House insurance Contents insurance Car insurance Landlord insurance Boat insurance Business insurance Commercial vehicle insurance Farm or lifestyle block insurance What insurance would you like a quote for? (You can select more than one insurance)* House insurance Contents insurance Car insurance Landlord insurance Boat insurance Business insurance Commercial vehicle insurance Solicitor's name (if known)Solicitor's email (if known) MortgageeBest time for us to get in touchAnytimeMorningAfternoonEvening