Referrals - Extend Marketing Partners

Refer Us a Client

Thanks for referring us a client! Please provide us with information on you as the referring agent and the company you are referring to us. Please keep in mind this is what we will use for tax purposes.

Referring Agent's Name(Required)

First Last

Referring Agent's Email(Required)

Referring Agent's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Referring Agent's Phone Number(Required)

Would you like to be setup in our system using your SSN or EIN?

Individual (SSN)

Business (EIN)

SSN\EIN

Company You Are Referring

Referral Terms

This is a referral only. I will not be actively participating beyond the referral. I understand that I will be eligible for a 3% commission on any initial setup fees for products purchased with a contract in place.

This is a current client of mine. I will be actively participating in the initial conversations. I understand that I will be eligible for a 5% commission on the initial setup fees and 3% on all monthly recurring products for 1 year based on the contract date.

This is a current client of mine. I will be playing an active role with eXtend in all of their marketing long term. I understand that I will be eligible for a 10% commission on any setup fees and 5% on all monthly recurring products for up to 5 years. After 5 years, terms can be renewed/terminated/adjusted based on current situations. If a new agreement is made, the new terms of the agreement will be agreed upon by both parties through an agreement or updated referral contract.

Business Name(Required)

Point of Contact(Required)

Business Email Address(Required)

Business Website

Information regarding the client you are referring

Let's Get You Paid!

Commissions are paid once the client is onboarded and payments are made in full.

Is this your first time referring us a client? If yes, please provide us your financial information for direct deposit of commissions.

Yes

Financial Institution for Direct Deposits

Bank Routing Number

Bank Account Number

Type of Account

Personal

Checking

Address of Bank (Street, City, State & Zip)

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.

Want to Schedule a Call?

1032 Madison Ave
Covington, KY 41011
859.999.7023

Refer Us a Client

Company You Are Referring

Let's Get You Paid!

Want to Schedule a Call?

Get In Touch!

Additional Resources