Authorized Retail Referral | Community Outreach Partners

COMMUNITY OUTREACH PARTNERS

Authorized Retail Store Referral

Secure submission

1Your information

2Retailer details

3Opportunity

Tell us who is making the referral

We use this information to credit and follow up with the correct referral partner.

Your Company NameYour nameYour emailYour phone

Retailer and primary contact

Enter the location and the person COP should contact about the opportunity.

Store name / DBALegal business namePrimary contactContact emailContact phoneNumber of locationsStore addressCityStateZIP codeWebsite

Opportunity details

A little context helps our team prepare before contacting the retailer.

What does the retailer currently sell?Estimated monthly store trafficPreferred contact methodCurrent carriers or service providersWhy is this retailer a good opportunity?

Information is used only to evaluate and follow up on this authorized retail opportunity.