Thank You for your continued support of Cogent Communications and your willingness to discuss Cogent with your peers.

We realize that taking time out of your busy day to discuss Cogent Internet services with another company costs you something.

We want to offer you a $100 American Express Gift Cheque for your help in making another company become a Cogent customer. But to qualify, you must have taken the following actions:

• You must be a current Cogent customer.
• Prior to filling out this form, you should have already spoken with the company about Cogent's high speed Internet service and received positive feedback regarding their interest level.
• You will need to know what current level of Internet service they have (dial-up, T1, T3, etc.).
• You must be able to provide basic contact information, including contact name, company name, and phone number.
• The company must be expecting a call from a Cogent sales representative.

If you have taken all these steps, then fill out the form below and submit your referral. The American Express Gift Cheque ($100) will be activated and mailed to you 30 days after the referred tenant becomes a connected Cogent customer. Thanks for your continued support of Cogent Communications!

Pre-requisites:
Have you already spoken with the tenant about Cogent's high speed Internet service and received positive feedback regarding their interest level?*
Yes
No

Is the tenant expecting a call from a Cogent sales representative?*
Yes
No

Your Information Name * Company Name E-mail * Phone * Country * Address 1 * Address 2 City * State / Province * Zip / Postal Code *

Referral Information Name * Company Name E-mail * Phone * Country * Address 1 Address 2 City * State / Province * Zip / Postal Code

What type of connection does this tenant currently have?*
Dial Up
DSL
T1
T3

Who is the service with?



Enter the code above exactly as you see it.



* mandatory field