Referrel Program
Client Referral Form
Instructions – Please fill in the blanks provided basic contact info of friends, family, neighbors, co-workers, etc. in the area so we can offer them the same quality that Countryside offered you. You DO NOT need to fill out all blanks to quality!
 |
Pricing Offer |
|
Action Taken |
Your Pocket |
Terms |
Free Inspection completed |
$10.00 |
n/a |
Inspection/Insurance/Contract |
$100.00 |
Inspection is performed with insurance adjustment and signed agreement by Homeowner. |
ALL NAMES DO NOT HAVE TO BE FILLED IN TO QUALIFY
Name_____________ Name_____________
(First,Last) (First,Last)
Phone_____________ Phone____________
Name_____________ Name_____________
(First,Last) (First,Last)
Phone_____________ Phone____________
Name_____________ Name_____________
(First,Last) (First,Last)
Phone_____________ Phone____________
