Referral Program Application Form

First Name *

Last Name *

Email *

Phone *

Payment Details

What is your preferred method of payment? *

Bank transfer, PayID, PayPal, Crypto, Account Credit

Bank Transfer
PayID
PayPal
Account Credit (for existing clients only)
Crypto
Other (please specify)
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Please provide your preferred bank account details for referral payments (if applicable).

Account Name
Bank Name
Account Number
BSB Number

Please provide your preferred PayID details for referral payments (if applicable).

Please provide your preferred PayPal details for referral payments (if applicable).

Please provide your referred crypto wallet address details for referral payments. We currently support BTC, ETH, and XRP. If you have other preferences, please reach out to our team and we will do our best to accommodate you (if applicable).

BTC Wallet Address
ETH Wallet Address
XRP Wallet Address
XRP Destination Tag

Note: If you're an existing client and you selected Account Credit, thank you! Our team will be in touch shortly to explain how it works and guide you through the next steps. We appreciate your participation and look forward to rewarding you as a Referral Partner!

Additional Information

How did you hear about our Referral Program?

Please select all that apply.

Kevin
Christo
Someone from The Level Up
Website
Social Media
Email
Other (please specify)
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What type of referrals do you wish to provide? (e.g., Small Businesses, Corporate, Non-Profit, Friends, Family, etc.)

Please select all that apply.

Small Businesses
Corporate
Non-Profit Organisations
Friends
Family
Acquaintances
All of the above
Other (please specify)
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Your Message

I agree to the terms & conditions provided by The Level Up. By providing my contact details, I agree to receive communications from this business.