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Referral Form

Used to referral prospects

YOUR COMPANY INFORMATION

Main Partner EMAIL ID
Please add your referral partner email (it is the MAIN email for your portal site (it may be the same or different than your personal email below). It is used as your partner ID #.
Company Name
First Name
Last Name
Email
Website
Include http:// in front of URL
Phone
Todays Date

CUSTOMER DETAILS

Contact information for the prospect you would like to refer

Customer - Company Name
Name of the Company referred
Company Address
Provide billing address (as much info as you know). OPTIONAL field--but REALLY helpful
Street Address
City
State / Province / Region
ZIP / Postal Code
Country
Prospect Contact Email

WHICH PRODUCTS?

List Products Referred (also include services, maintenance, anything you talked to them about)
How Many Users?
Estimate the number of potential users
How Soon?
Apx how soon are they looking to make a decision?
What are they using currently and what other options are they considering?
What have you told/shown them so far? Any unusual circumstances or dynamics (the IT guy makes the decisions, but sales recommends, etc.).