CenturyLink™ Customer Referral Form - Residential

Thank you for your interest in submitting a CenturyLink™ Customer Referral. We are pleased that you are happy with your service and want to refer someone who will enjoy the same benefits. NOTE: Ohio, North Carolina, Tennessee, Virginia, New Jersey and Nevada customers and referrals are not eligible for the program.

Prior to referring CenturyLink™ service, check availability by simply clicking on Availability. Please enter the address of the person you wish to refer and hit enter. If your referral is capable of receiving CenturyLink Local Service in their home, you will be directed to the New Services page. If they are eligible, you can submit a referral for CenturyLink services.

Prior to referring CenturyLink PRISM™ TV, check availability by simply clicking on Availability. Please enter the zip code of the person you wish to refer and hit enter. If your referral is capable of receiving CenturyLink PRISM TV in their home, you will be directed to the Prism Home page. If they are eligible, you can submit a referral for CenturyLink PRISM TV.

Prior to referring High-Speed Internet, check availability by simply clicking on Availability & Pricing. Please enter the area code and phone number of the person you wish to refer and hit enter. If your referral is capable of receiving High-Speed Internet in their home, the following message will appear, “Great News! High-Speed Internet service is available in your area.” If they are eligible, you can submit a referral for High-Speed Internet.

Please indicate whether this is a New Customer referral or an Existing Customer referral, check the product box(s) you would like to refer, and complete all of the form information below.

New Customer Referrals

If the person you refer activates new service and signs-up for the selected product within 60 days of your referral, you will be notified and a $50 credit will be issued to your account. To receive this credit, the person you refer must sign-up and have an active account. You may receive one $50 credit per referred person. Plus, let your friends and family know they will get an extra $10 off the current promotional price for six months!

Existing Customer Referrals

If the person you refer signs-up for the selected product within 60 days of your referral, you will be notified and a $25 credit will be issued to your account. To receive this credit, the person you refer must sign-up and have an active account. For multiple selected products, you are eligible for a $25 credit per product. Plus, let your friends and family know they will get an extra $10 off the current promotional price for six months!

We appreciate your interest and encourage you to refer as many people as you want. The more you refer, the more credits you can earn!

Starred ( ) items are required.

Referral Type:  New Customer Referral  Existing Customer Referral

Referral Products:  CenturyLink PRISM TV  High-Speed Internet  DIRECTV® service through CenturyLink

Your name:

First Name Last Name Address City   State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip   Your CenturyLink Home Telephone Number: (  )   -   Your e-Mail Address:

Your referral's name:

First Name Last Name Address City   State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip   Did you check your referral's address, phone number and zip code for availability and coverage for CenturyLink PRISM TV, local service or High-Speed Internet?

Referral's Home Telephone Number:

(  )   -

Referral's e-Mail Address:

   

CenturyLink™ Customer Referral Program (“Program”) Terms & Conditions In order to participate in the Customer Referral Program (“Program”), referring customer must have an active residential CenturyLink account in one (1) or more CenturyLink local service areas. Ohio, North Carolina, Tennessee, Virginia, New Jersey and Nevada customers and referrals are not eligible for the program. Business accounts not eligible for credits. CenturyLink employees and their immediate family members are not eligible to refer. Program is subject to change and may vary by service area. CenturyLink reserves the right to add, change or remove any part of the Program or discontinue the Program at any time. All Program Participants must maintain a qualifying CenturyLink account in good credit standing to receive all applicable Program credits as allocated below. Referring Customer: Referring customers receive $50 credit when a new CenturyLink referred customer subscribes to a qualifying service such as CenturyLink™ PRISM™ TV, CenturyLink™ High-Speed Internet or DirecTV through CenturyLink (“Qualifying Service”). Referring customers receive $25 credit when an existing CenturyLink referred customer adds a Qualifying Service through CenturyLink. The $50 and $25 will be in the form of credits on the CenturyLink bill. Referring customer is entitled only to one credit per month. Limit $600 in credits per calendar year. Please allow 30 days from the date referred customer orders the service for your credits to appear on your bill. Referred Customer: Referred Customer will receive $10 off each month on one Qualifying Service for 6 consecutive months assuming service availability. The Qualifying Service must be installed within 60 days of the initial referral date by Referring Customer. Customer must maintain the service for six months to receive full $60 savings.