Request – EraseItNow.com

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Active Clients Only

THIS IS A SUBMISSION FOR CONSIDERATION — NOT ACCEPTANCE.
EACH REFERRAL PLACES YOUR NAME AND YOUR CLIENT CODE UNDER SCRUTINY.

EVERY INDIVIDUAL YOU PUT FORWARD REFLECTS DIRECTLY ON YOUR JUDGMENT.

WE RESERVE THE RIGHT TO DENY ANY REFERRAL WITHOUT EXPLANATION OR NOTICE.

Client Referral Request

Your information

Your Full Name or Company Name(Required)

Your Active Client Code(Required)

Your Contact Email(Required)

Who You Are Referring

Full Name of Referred Individual or Entity(Required)

Their Known Alias / Professional Name (if applicable)

Primary Occupation / Role(Required)

Location(Required)

Why You're Referring Them

In your own words, why are you referring this individual to Erase It Now?(Required)

How You Know Them

How long have you personally known this person?(Required)

Less than 6 months

6–12 months

1–3 years

Over 3 years

What is your direct relationship with them?(Required)

Professional

Personal

Both

Other (explain below)

Explain how you know them — and why that matters

Have they been briefed on our process, referral requirements, and exclusivity?(Required)

Yes – thoroughly

Yes – somewhat

No – they are unaware

I prefer not to disclose

Final Considerations

Is this individual likely to use our services for themselves, or on behalf of others (as an agent/rep)?(Required)

For themselves

On behalf of someone else

Unknown

Do you believe this referral strengthens the network of Erase It Now? Why?

Legal & Ethical Acknowledgements

I understand that referring this individual does not guarantee their acceptance.(Required)

I understand that referring this individual does not guarantee their acceptance.

I understand that referring this individual does not guarantee their acceptance.(Required)

I understand that my referral history reflects on my account status and future privileges.

I understand that referring this individual does not guarantee their acceptance.(Required)

I confirm that this individual was not encouraged to contact Erase It Now directly.

I understand that referring this individual does not guarantee their acceptance.(Required)

I agree that if this referral violates Erase It Now’s policy or security, my own access may be permanently revoked.

CAPTCHA

You will not receive an update unless further clarification is needed. If accepted, your referral will be contacted. If denied, nothing follows.