Information about you
- referrer

Shell No. * Serial No. First name * Last name * Company name Address * Address 2 City * State * select Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Zip code * Phone number * Purchased from *

Information about referee
- person who purchased IQAir air purifier(s) on your recommendation

Serial No. (if known) First name * Last name * Address * Address 2 City * State * select Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Zip code Phone number *

Yes, I agree to the terms and conditions and certify that the above information is correct. *

Terms and Conditions: The referrer (you) and the referee must be registered warranty customers. Referral claim must be received within 6 weeks of referee's purchase. Pre-filter will be shipped to you when referral sale becomes final. Limited to one pre-filter per referral. Please fill out one card per referral. Allow 4 weeks for shipping. Self referral is not eligible. The IQAir Referral Program is not available to IQAir Dealers, Resellers, Retailers, Builders or Installers. The Program terms and conditions are subject to change without notice.

Mandatory fields are marked with an asterisk.