Rousseauís Referral Form our 32nd Year

4415 Evangel Circle, Huntsville, AL  35816
256-837-2762 Fax 800-342-7523    email:
ext 256-520-1740

I, ___________________________ Am referring the following customer____________________POC______________________, Address_________________________________
City____________State___, Zip__________ Phone________________________________
to Rousseaus, of which said customer will likely need the following service/product:

Awards, Trophies, Plaques, Glass, Acrylics,

Name Badges, Rubber Stamps, Embossers  Quantity____/_____

Promotional Products,  Quantity____/_____

Screen Printed Sportswear-T-shirts, hats, Team Uniforms, Jackets, Warm-ups, Sweat shirts,
Embroidered Garments,  Other________________________________Quantity____/_____

CDís Duplicated, DVDís Duplicated, Labels for CD/DVDís, (Absolutely no Unauthorized materials accepted. ) Quantity____/_____

Media/Web services: Web Hosting, streaming Media hosting, Web creation, streaming Media creation and Edition, Quantity____/_____  
Institutional Sports Consulting - fitness, athletic equipment, facilities construction, and modification,
Business Consulting-up to and including Lobbying and support activities.
Furniture Refinishing, Repair, Stripping, Other___________________/_____
Quantity____  Bonus on 3+, 5+, 10+, 20+, 50+ items

Real Estate: Referrals accepted on sellers, buyers and brokers. However, state laws and Realtor association rules may apply and will be adhered to first.

This adherence may prohibit a financial award to the referring customer.Quantity____/_____
I realize I may receive a financial award from Rousseau's for said referral and therefore an Internal Revenue Service W-9 Form will be submitted if warranted for said award. I am therefore filling out the following W-9  form to facilitate my prospective payment. Payment will be done via business check once Rousseauís has received full payment of the accepted referral. Download IRS Form W-9 here: