Pure Aesthetics Application For Referral Program
First and Last Name: *
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Email: *
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Address: *
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Phone Number: *
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Business Name: *
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Business Address: *
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Social Security or IEN # *
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Address to mail check/rewards to: *
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Terms and Conditions:
Welcome to our partnership referral program! Refer a Client and get Paid! Every time you refer a client, friend, family member to Pure Aesthetics and Massage Center and they purchase a Body Contouring Package you will receive:

$25 for a package of 7 series
$50 for a package of 14 series
$75 for a package of 21 series

AND receive an additional $25 GIFT CERTIFICATE to be used at Pure Aesthetics and Massage Center once your referral completes payment of their package in full.WE will mail you a check and or Gift Certificate on the 15th of every month. Pure Aesthetics and Massage Center may terminate this agreement at any time for any reason or no reason by writing a notice to partners/other party.
I have read, understand ,accept and agree to the terms and conditions above: *
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