Form

Refer a friend to NLBC / NLTC and you can earn $50 for yourself and your friend. Simply fill out the form below and you’re on your way to earning money.

Your contact information here:

First name

Last name

Refer Date (today's date)*

Street address

City

Email*

Who are you referring to NLBC?

New Customer Name *

Please provide First and Last name, Address, City, Phone number, and Email address.

Terms and Conditions: By filling out and sending us this document below, you agree to the terms and conditions of the NLBC/ NLTC Referral program. You agree to have this form turned in before the installation of services is completed. If the form is turned in after installation is completed, this form and referral is considered null and void. You also understand that both parties will receive a $50.00 bill credit applied to their respective account once the new customer has completed two billing cycles and has paid their bill before the due date of the 20th day each month and is considered in good standing and current with their NLBC / NLTC bill. You also understand that if you are the referring customer, that you must be in good standing and considered current with your NLBC / NLTC bill before the $50.00 credit can be applied.

Click the box to accept the T&Cs

Agree to Terms & Conditions*