ZigaForm version 5.7.1

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)
Please ensure the email entered above matches your email on file or else the lead attribution may be voided. This is your (the Affiliate) email address

Contact's Information

Name(Required)
This is the email address of the person you are signing up. It must be correct or you will not get credit when they purchase. DO NOT ENTER YOUR AFFILIATE EMAIL ADDRESS IN THIS FIELD
Do they wish to be contacted by a MagnaWave specialist?