Customer Reference Program Enrollment Form

Customer Reference Program Enrollment Form — Form Fields

This sales template includes 10 fields. Enroll satisfied customers in a formal reference program for peer calls, case studies, and speaking engagements. Free to customize and use on ZenBuild.

• Customer Name (text, required)
• Company Name (text, required)
• Customer Email (email, required)
• Job Title (text, required)
• Reference Activity Willing to Participate In (dropdown selection, required) — options: Peer Reference Call, Written Case Study, Video Testimonial, Speaking Engagement, Press Quote, Advisory Board
• Industry (dropdown selection, required) — options: Technology, Finance, Healthcare, Manufacturing, Retail, Government, Education, Other
• Years as a Customer (number, required)
• Likelihood to Recommend (1–5) (rating, required)
• Why They Love the Product (long text, required)
• Approved by Account Manager? (multiple choice, required) — options: Yes, No