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Client Referral Form

At CaraSure we are very proud of our heritage, being passionate, committed and service driven. It was therefore necessary to create this Referral system and acknowledge and provide incentives to those who always refer their friends and family to us.

Please provide us with your details and the person you wish us to contact and making them part of the CaraSure Family.

MY DETAILS
(Referrer)

MY FRIEND/FAMILY MEMBER
DETAILS (Referral)

Your relationship

DECLARATION

I hereby declare that all the information provided above is true and correct. I also confirm the person I referred to CaraSure is familiar with my intentions that a consultant from CaraSure will be contacting them.

I further understand that CaraSure will ONLY use this name for the purposes of CaraSure’s business and that this name will not be forwarded to other person and/or institution/company.