Submit A Referral

Referral Rewards

Referrer Information

The referrer is the person making the referral
First name of the person making the referral
Last name of the person making the referral
Email address of the person making the referral to send updates about reward progress. A VALID EMAIL ADDRESS IS REQUIRED TO SUBMIT THIS FORM OR IT WILL BE REJECTED AS SPAM.
Phone number of the person making the referral in case we have questions about your referral or your reward
Referrer Mailing Address *
Referrer Mailing Address
City
State/Province
Zip/Postal
This is the address where the referral reward will be sent

Referral Information

The referral is the person being referred to Premier
First name of the person being referred to Premier
Last name of the person being referred to Premier
Email address of the person being referred to Premier
Phone number of the person being referred to Premier. We need this so we can contact them to make an appointment with them to inspect their roof.
Referral Address *
Referral Address
City
State/Province
Zip/Postal
The address of the property being referred
Any details or specific information you can share about the project you are referring are welcome
If you have a specific representative at Premier you wish to receive this referral, please put their name here. Otherwise, your referral will be assigned to a Premier Representative who is working in your referral's neighborhood.
Put your first and last name here if you are filling out this form on behalf of the referrer
Program Details *