EmPower MD Referral Form

1. During your audit:

Any friends or family members that you have that could actually and truly benefit from the EmPower MD funds, submit their information during this audit. Call or text them and zero in on a good day for the audit. We are available Monday- Friday, morning arrivals are at 9am. Afternoon arrivals are at 1 pm. For each referral, you will unlock an additional $75 - $150 in funding toward your project. Furthermore, AHE will issue you $50 per referral. Any referrals you give will have their audit performed FREE OF CHARGE. It helps you, it helps them, it helps us spread the word.

2.Submit Referral Form:

We can only apply the extra funding toward your project if the form is included upon submission of the audit itself. Any referrals submitted after today through your AHE app, will qualify you for an additional $50 per from AHE.

Referral #1- Full Name

Referral #1- Address

Referral #1- Phone Number

Referral #1- Email

Referrals Email *

Referrals Phone Number *

Referral #2- Full Name

Referral #2- Address

Referral #2- Phone Number

Referral #2- Email

Referral #3- Full Name

Referral #3- Address

Referral #3- Phone Number

Referral #3- Email

Referral #4- Full Name

Referral #4- Address

Referral #4- Email

Referral #4- Phone Number

Referral #5- Full Name

Referral #5- Address

Referral #5- Phone Number

Referral #5- Email