Referral Agent Application
Complete this application to express interest—reviewed applicants may be contacted in about two weeks.
Applicant Information
Full legal name
*
First Name
Last Name
Preferred name
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City and State
*
Best way to contact you
Email
Phone
Text
Best time to contact you
Promotion & Experience
Do you have experience with referrals, sales, marketing, or social media promotion?
Yes
No
If yes, please provide details (optional)
Which social media platforms do you use?
Instagram
Facebook
TikTok
Pinterest
None
Other
Social media handles or profile links (optional)
How would you promote Luxe Wealth Solutions?
Distribute approved flyers
Share approved social media content
Tag Luxe Wealth Solutions in qualifying posts
Refer family and friends
Connect interested people with our services
Other
Where could you distribute flyers or promote services? (optional)
Estimated availability for approved promotional tasks (optional)
Program Understanding
Please confirm your understanding of the following program requirements:
*
I understand this is an application and submitting it does not guarantee acceptance.
I understand I must use only approved promotional materials and follow program guidelines.
I understand I must not make misleading claims or promise guaranteed tax, credit, or funding outcomes.
I will not collect or share another person's sensitive financial, tax, credit, or identity information through this application.
I understand compensation is subject to written program terms and approval of qualifying activities/referrals.
Note: Any hourly promotional compensation, qualifying funded-client referral bonus, and raffle eligibility will be governed by separate written program terms. Do not submit any bank account, SSN, tax return, credit report, or other sensitive financial data.
Applicant Acknowledgment
Type your full legal name to acknowledge this application
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I confirm that the information provided in this application is accurate to the best of my knowledge.
*
I confirm the information provided is accurate.
Submit Application
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