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Customer Referral Form
Atlanta Flooring Resource & Design
A Division of Atlanta Carpet Services
We Accept all Major Credit Cards
Referral Type:
Customer Name/Job Name:
Property Address:
City & State:
Zip:
Amount of Sale
Referral Amount
$1,000
$2,000
$3,000
$4,000
$5,000
$50
$100
$135
$175
$225
Name:
Referrer/Payee Information:
Phone Number:
Address:
City & State:
Zip Code:
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Required Information
Thank you for your referral
We appreciate it!
Email Address:
Email Address:
