Customer Referral Form

We appreciate your introduction to a potential new satisfied customer!

REFERRED BUSINESS

Contact Name *
Business Name *
Email *
Phone No *
Website
Mailing Address
Why are you Referring this Business? *
Your Name *
Business Name *
Email Address
Phone *
Mailing Address
I have personally contacted the business being referred above and the contact person. I have identified and agreed to a Stratus NZ Ltd representative contacting them. I have read and agree to the TERMS & CONDITIONS of the Stratus NZ Ltd referral promotion.