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 and North Carolina 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™ Advanced 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 Advanced TV in their home, you will be directed to the programming and packaging page. If they are eligible, you can submit a referral for IPTV.

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 Advanced TV  High-Speed Internet  DISH Network® Satellite TV from 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 Advanced TV, local service or High-Speed Internet?

Referral's Home Telephone Number:

(  )   -

Referral's e-Mail Address:

   

CenturyLink™ Customer Referral Program (“Program”) Terms & Conditions Services may not be available everywhere. CenturyLink may add, modify or delete any terms of the Program at its discretion without notice. Additional restrictions may apply. Ohio and North Carolina customers and referrals are not eligible for the program. The submitter (“Submitter”) is defined as the person who submits the name(s) and information of the referral (“Referral”). The Submitter must be an existing CenturyLink™ residential customer in good credit standing and has not earned over the maximum of $600 a year in referral credits. The Submitter must submit the official, fully completed online CenturyLink™ Customer Referral form (“Form”) at centurylink.com/referral to be eligible – no written or verbal referrals accepted. Submitter may submit multiple referrals. The Referral is the individual who is being referred – either a new customer to CenturyLink (“New Referral”) or an existing customer of CenturyLink (“Customer Referral”) adding a new CenturyLink™ service to their existing account. CenturyLink may reject any Referral at its sole discretion. In order for the Submitter to be eligible for an invoice credit (“Credit”), the Referral must sign up for a qualifying service (“Qualifying Service”). Qualifying Services include: Residential High-Speed Internet and/or DISH Network® Satellite TV from CenturyLink. The Referral must activate the Qualifying Service within 60 days of the submitted Form (according to date and time of online entry). CenturyLink may change any of the Qualifying Services at any time without notice. Submitter will receive one $25 Credit per Qualifying Service for Customer Referral and one $50 Credit for New Customer with qualifying services. The Credit will be applied to the Submitter’s applicable invoice approximately 60 days after the Referral’s Qualifying Service has been activated. Referral’s Qualifying Service must be activated within the 60 days of the submitted Form. Only one $25 Customer Referral Credit or one $50 New Referral Credit will be applied at a time to a Submitter’s invoice; additional Credits will be applied to subsequent Submitter’s invoices. The first Submitter to submit a Referral (according to date and time of online entry) will be eligible to receive credit if multiple entries are received on same Referral. After 60 days, the entry is no longer valid but the Submitter may resubmit Referral. Accumulated Credits do not have cash value and are not redeemable for cash. All Credits will be forfeited if the Submitter cancels their CenturyLink Service or becomes ineligible to participate in the Program.