Referral Form

1. Submit Your Referral

  • Tell us a little about yourself and the person you are referring to us using the form below.
  • Enter as many referrals as you like.
    • Just make sure to fill out all information each time. Please help us be sensitive to the privacy wishes of those who you refer. Only refer companies and contacts you believe would enjoy learning more about Kittiff EMC.

2. Get Your Entries

  • You will be entered into a drawing for a new iPod Nano.
  • Each qualified referral will earn you one entry into the drawing.
    • *If you submit more than 10 referrals in one month, your chance to win will double! Example: Submit 10 referrals and earn 20 entries into drawing, submit 11 referrals and earn 22 entries, etc.*

3. Receive More Rewards For New Business

  • If your referral leads to new business, you'll automatically receive a new iPod Nano!
  • If your referral turns into new business within 6 (six) months of submission, you'll receive one of the new iPods.
    • *Already have an iPod? Choose a $150 gift certificate to iTunes, Apple's exclusive online store for iPod tunes and accessories, or an American Express gift certificate.*

4. Get The Good News!

  • Winners will receive notification via email.
  • Prizes will be sent to the address you provide to us in your email reply.
  • Start enjoying your reward! It's just one more way we can say Thank You.

Submit Your Referral!

Please fill in the form below
All Fields are Required.


  • Your First Name:

  • Your Last Name:

  • Your Company Name:

  • Your Email:

  • Phone Number

  • Referral Company:

  • Referral First Name:

  • Referral Last Name:

  • Referral Email:

  • Phone Number

  • City

  • State


Or, call us toll-free if you would like more info.