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Refer a Client

IMPORTANT: If you haven't already done so, please visit our Discounts & Rewards page for information and instructions regarding this page. If you're prepared to proceed, then please take a few moments to complete the forms below. Please see our Eligibility Requirements before proceeding. Thank you for your participation!

REFERRAL FORM:

Leave a Testimonial

Information for Client Verification:  (your information)

*Full Name:

*Business Name:

Address:

City:

State:

Zip:

Phone:

*Email:

Information About Referred Client:  (potential client information)

*Referred Name:

*Referred Business:

Referred Address:

Referred City:

State:

Zip:

*Referred Phone:

Referred Email:

*Comments:

*Contact Reference:


yes


no

May we use your name as the referring party when contacting potential client?

Continue to Reward Selection on Right
Continue to Reward Selection Form on the
Right Before Submitting...

Choose Your Reward:
(You may request your reward below if none of the listed choices appeal to you)

(1) ONE REWARD PER SUCCESSFUL REFERRAL.

No Gift Necessary - (Complimentary Referral)

Thompson's Floor Care - ($30.00 off Services)

Sidewalk Cafe - ($25.00) - (Conover, NC)

Health Hut - ($25.00) - (Hickory, NC)

Cornerstone Bakery - ($25.00) - (Hickory, NC)

Starbucks Gift Card - ($25.00)

Barnes & Noble Gift Card - ($25.00)

Olive Garden Gift Card - ($25.00)

Office Depot Gift Card - ($25.00)

Target Gift Card - ($25.00)

Walmart Gift Card - ($25.00)

(Requested) Gift Card - ($25.00)

If Primary Choice is not Available, Choose Alternative:
(Different selection than above)

No Gift Necessary - (Complimentary Referral)

Thompson's Floor Care - ($30.00 off Services)

Sidewalk Cafe - ($25.00) - (Conover, NC)

Health Hut - ($25.00) - (Hickory, NC)

Cornerstone Bakery - ($25.00) - (Hickory, NC)

Starbucks Gift Card - ($25.00)

Barnes & Noble Gift Card - ($25.00)

Olive Garden Gift Card - ($25.00)

Office Depot Gift Card - ($25.00)

Target Gift Card - ($25.00)

Walmart Gift Card - ($25.00)

(Requested) Gift Card - ($25.00)

*Agreement:

By checking box you agree that you have read and agree with the Eligibility Requirements.


* Denotes Required Field

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