BizCom Web Services Referral Form

Referral Form

Complete the fields in the form below and we will follow up with the referred person. If your referral results in a new BizCom sale within 60 days, you will be sent a check equal to 5% of the initial sale for Website design and/or Web Application Development solutions1, or 30% of the first three full months recurring charges for Managed Servers, Hosted Microsoft Exchange, SharePoint, Office Communications Server (OCS), Dynamics Customer Relationship Management (CRM) or Email Archiving.

1 applies to cost of site or application development only. It excludes any shipping, custom photography, translation services and tax.

 

REFERRAL INFORMATION
Salutation:
First Name:
Last Name:
Company Name:
E-mail Address:
Phone Number:
Alternate Phone Number:
Best Time to Call:
Address:
City:
State:
Zip:
Service Interest:
Next Step / Notes:
Send Check to:
YOUR INFORMATION
Salutation:
Your First Name:
Your Last Name:
Your Organization Name:
Your E-mail Address:
Your Phone Number:
Your Address:
Your City:
Your State:
Your Zip:
Enter Text Above:

Can't Read It?
Click Below

 
Note: A W-9 must be on file for payments to be released (except to charities and rebates to the referrals). If the total Payments exceed $600 in a year, BizCom will send a 1099.

Payments for design and development services are made on the 10th of the month following receipt of the deposit; payments for hosted services will be made on the 10th of the month following the payment for the 3rd month of services.
 

BizCom will never share, sell or trade your information for any reason.
Please review our Privacy Policy for additional information.
 

Raleigh Website Design | Contact Us

Toll Free: 866.253.4316
Office: 919.855.8399

Customer Testimonials

"I was relieved that Don Rodger and his team were, first of all attentive to my suggestions and what I thought the site should be, and secondly, their professionalism in pulling the whole thing together."

Danny Moody
Executive Director
NC Supreme Court Historical Society