Southland Referral Form

3 Out of 5 New Customers Are Referred To Us by Our Satisfied Customers

You can earn up to $1000.00 just by referring family or friends to us. It's simple. Just fill out this referral form below and submit. If your friend or family member builds a home with us, we will gladly send you a check for $500.00 plus a $500.00 down payment coupon that you or your friend or family member may use toward the purchase of a new Southland home! We will also send a copy of our new Homeplan Catalog to your referral person(s). You can also print & and email this form to [email protected] or fax it to 770.428.8942. If you like, call us at 770.428.2320 extension 0 and we'll be happy to fill out a form for you over the phone.

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Your Information

*Denotes Required Field
*First Name:
*Last Name:
*E-mail:
*Address:
*City:
*State:
*Zip:
Home Phone:
Cell Phone:

Referral's Information

*First Name:
*Last Name:
*E-mail:
*Address:
*City:
*State:
*Zip:
Home Phone:
Cell Phone:
Relationship:
Friend
Family
Other