RapidReferral PROGRAM

Know a Friend or Business Who Could Benefit from Rapid Refill's Quality Products and Services? Treat Them to $5 off Their First Purchase and You'll Earn a $5 Gift Card.

Here's how our referral program works:

1.  Print & Complete this form.  Give it to a friend or business and tell them about Rapid Refill's great products, service and value.

2.  When the person you referred brings their empty cartridge for exchange and presents this form, they will receive $5 off their first purchase.  And, we'll send you a $5 gift card as a "thank you" for helping us spread the word!

Please note:  May not be combined with any other offers.  Referral must be a first time customer.  Valid at this location only.  Valid only on Rapid Refill brand products, not OEM.  Cashier use code: 352.

YOUR NAME: __________________________________________________________________________

MAILING ADDRESS:  _____________________________________________________________________

CITY: ____________________________________ STATE: _____________   ZIP: _____________________

PHONE: ______________________________________________________

EMAIL: ________________________________________________________________________________

 CIRCLE ONE:                                                                                       '