Referral Intake Form

Referrer (Your) Name

Referrer (Your) Address

Referrer (Your) Email

Referrer (Your) Phone

Is the Referrer (You) a G2 Customer?

Yes

Referral Name

Referral Address

G2 Branch Closest to Referral

Denver

Ft. Collins

Colorado Springs

Eastern Plains

Referral Email

Referral Phone

Additional Information About Project Any details or specific information you can share about the project you are referring are welcome.

G2 Representative If you have a specific representative at G2 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.

Program Details I have read the program details and understand how the G2 Referral Rewards Program works.

Yes

I am submitting this form on behalf of the Referrer and understand that if they do not understand the process that I will be responsible.

Read the program details here.

Person Filling Out This Form (if not Referrer) If you are filling out this form on behalf of the referrer, please put your name below.

‹ › ×