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Business Referral Agreement
Quality Systems Integrators
P.O. Box 91
Eagle, PA 19480
The QSI Business Referral Program is designed to offer participants an incentive for referring business
opportunities to Quality Systems Integrators. As a participant, you will receive financial compensation for
a referral when it results in a successful new sale of our TMSWeb product. The compensation is a minimum
of $5,000.00 and could be higher based on product and services purchased.
Please Note: This referral will not be considered a recommendation by the participant but a cost effective
alternative for prospects to evaluate. The prospect is still expected to perform appropriate and thorough
due diligence before selecting a Quality Management System.
If you would like a presentation of our product please contact our office to schedule a one-on-one WebEx
demonstration. We will be happy to show you our product and answer any questions you may have.
Start referring today by filling out the information below. Please note all information is held in strict
confidence and will not be shared with anyone. If you have additional questions about our Business
Referral Program, contact QSI at 800-458-0539.
Company Name: ______________________Street Address: _________________
City: ______________________ State: ______________________ Zip: ________
Telephone #: __________________E-Mail: ______________________________
Contact Name: ____________________________________________________________
Company Name: ____________________________________________________
Telephone #: __________________ E-Mail: ______________________________
Do you think your referral could benefit from Quality Automation?
Is your referral FDA regulated?
Can we use your name when contacting your referral?
Other information you would like to share with us about your referral.
Fax this form to 610-458-7555 or e-mail to email@example.com. You may also submit referrals online at