Business Partner Referral Form

Business partner details

Asma Munshi - Kiwi Cheap Cars

Name (referrer) *

First

Last

Phone number (referrer) *

Email (referrer) *

Company name (optional)

Customer details

Name (customer) *

First

Last

Date of birth (customer)

Pop in the Date of Birth if you know it. If not, no worries – just leave it blank!

Phone number (customer) *

Email (customer) *

How can we help

Type of referral *

Does the customer have a car in mind? (optional)

What is the expected price of the car? (optional)

Rego of the car the customer is looking to purchase (optional)

(If you already know)

Please provide further details on the type of referral *

Please let us know how we can help

Is there any document or file you would like to upload to provide additional information?

File 1

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File 2

Add another file

File 3

Business Partner – Referral Form