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Customer Referral Form
We appreciate your introduction to a potential new satisfied customer!
REFERRED BUSINESS
Contact Name
*
Contact Name
*
Business Name
*
Business Name
*
Email
*
Email
*
Phone No
*
Phone No
*
Website
Website
Mailing Address
Mailing Address
Why are you Referring this Business?
*
Why are you Referring this Business?
*
REFERRED BY:
Your Name
*
Your Name
*
Business Name
*
Business Name
*
Email Address
Email Address
Phone
*
Phone
*
Mailing Address
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.
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