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CONFIRM REFERRAL
Name
(Required)
First
Last
Email
(Required)
Organization
(Required)
I confirm I recommended ZAPP to another organization.
(Required)
Yes
Is the email listed on this form the email to send the gift card to, should the referred organization sign up for ZAPP?
(Required)
Yes
No
Please enter the email we should send the gift card to below.
(Required)
Name
This field is for validation purposes and should be left unchanged.