Candidate Referral Form
Email address *
Referral Guidelines
1. Please complete this form in its entirety and submit it in order to refer a candidate to Lumaxia Consulting, LLC.
2. Referring an external candidate allows you to be eligible for a referral award based on the chart below.
3. If the candidate you refer is hired as a result of the referral, you will receive the referral amount after
the candidate completes 90 days of service.
4. For a single candidate, there is one referral award only. If a single candidate is referred by more than
one employee then the first referral received will be eligible for the referral award,
provided the candidate is hired.
5. Employees who are a part of the hiring decision for a particular position are not eligible for
the referral program.


Type of Placement Referral Payout

Contract $250

Temp to Perm (Contract to Hire) $250

Full Time/ Perm (Based on Salary)
Up to $100K $300
$100 - 200K $400
$200 - 300K $500
$300 - 400K $600

Your Information
Name *
Contact Number
Email ID *
Candidate I am Referring
Candidate Name *
Contact Number *
Email ID *
Position Referred For
Please complete this referral form to be eligible for referral reward. For any questions call us at 508-466-8193 - Thank you.
Lumaxia does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor. We are an Equal Employment Opportunity Employer.
Never submit passwords through Google Forms.
This form was created inside of Lumaxia Consulting, LLC.. Report Abuse