Partner Referrals

Partner Information

Parnership Information

Smash Repairer

Tow Truck Operator

Business Name(Required)

ABN

GST Registered?(Required)

Yes

Address(Required)

Contact Name(Required)

Contact Number(Required)

Email(Required)

Partner Reward Payments

Keep You Driving Rentals will issue a recipient-created tax invoice for the payments made under this Agreement.

Please select how you would like Referral Rewards to be paid(Required)

EFT

Gift Card

Banking Details(Required)

Name of Bank Account Name BSB Account Number

Gift Card Reward(Required)

New Gift Card

Existing Gift Card

Existing Card Number

Partner Acceptance & Authorisation

By providing your details, you consent to us contacting you about our products and services. Keep You Driving’s Privacy Policy contains information about how you can access and correct your personal information, how to make a complaint, and how we deal with complaints and can be found at www.keepyoudriving.com.au/privacy-policy/

Keep You Driving Rentals may complete any or all of the following information if omitted by the Partner:

Date of this agreement;
Keep You Driving Representative;
Vehicle Repair Declaration

Authorised Name(Required)

Signature(Required)

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Date

Keep You Driving Representative

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KEEP YOU DRIVING PTY LTD

Name

This field is for validation purposes and should be left unchanged.

Partner Referrals

Partner Information

Partner Reward Payments

Partner Acceptance & Authorisation

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