My Rewards - An Image Products Solution

Customer Referral

Complete the information below to refer a bank or credit union to My Rewards. If your referral signs a contract between now and June 1, 2008, you will be awarded 25,000 My Rewards points. Refer as many customers as you like.

*Your Name:
*Bank or Credit Union Name:
*Your Email Address:
*Your Phone:
Person whom you are referring:
*Name:
*Bank or Credit Union Name:
*Title:
*Street Address:
*City:
*State:
*Zip:
*Phone:
*Email Address:
Comments or special instructions related to your referral:

Fields marked with an asterisk * are required.