Refer A Friend

MagnaWave Affiliates please list YOUR information under the Affiliate Section and enter your referrals information under the “Contact Information” Section. *To be considered a MagnaWave affiliate, you must have previously signed up and submitted the affiliate documentation.

*Please note by registering this lead, you understand that the client may occasionally receive informational emails from MagnaWave and you, the affiliate, give the company permission to do so.

Affiliate Name(Required)

First Last

Affiliate Email(Required)

Contact's Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Do they wish to be contacted by a MagnaWave specialist?

Yes

What Questions do they have? What machine are they interested in?