Previous Customer Referral Program (2025) Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Your InformationYour Name *FirstLastYour Email *Your Phone *Your Address *Address Line 1Address Line 2CityNew JerseyAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeReferred Household InformationReferred Customer Name *FirstLast Your Customer Date Referred Customer Email *Referred Customer Phone Number *Referred Customer AddressAddress Line 1Address Line 2CityNew JerseyAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreferred Method to Receive Gift Card: *Email – Delivered within 1 weekText Message (SMS) – Delivered within 1 weekMail – May take a minimum of 1 monthChoose how you’d like to receive your reward after the referred household completes their audit.Terms and Conditions *I agree with GreenLife’s Referral Program terms and conditions To be eligible for the referral reward, the following conditions must be met: The referred household must meet the eligibility guidelines of the NJ Comfort Partners Program. The referred household must schedule and complete a home energy audit through the program. The referring individual must be a previous GreenLife customer who received services within the 6 months prior to the date of the referred household’s completed audit. GreenLife reserves the right to modify, suspend, or terminate this referral program at any time, for any reason, without prior notice. Referral rewards will be issued only after all conditions have been satisfied and verified by GreenLife Energy Solutions.Signature * Clear Signature Date *SMS Privacy Disclaimer *I consent to receiving text messages from GreenLife Energy SolutionsBy submitting this form and signing up for texts, you consent to receive text messages from GreenLife Energy Solutions at the number provided, including messages sent by auto dialer. Consent is not a condition of purchase. Msg & data rates may apply. Msg frequency varies. Unsubscribe at any time by replying STOP or clicking the unsubscribe link (where available) and no further messages will be sent. Reply HELP for help. View Privacy PolicySubmit
