Referrer Name
Referrers # - (REQUIRED) Enter a number for the Referrer. This can be any number you wish as long as it is unique to the Individual.
Last Name - (REQUIRED) Enter the Individuals Last Name.
First Name - (REQUIRED) Enter the Individuals First Name.
Phone # - (OPTIONAL) Enter the Individuals Phone number. Formatting the phone is left up to you.
Email Address - (OPTIONAL) Enter the individuals Email address.
Buttons
Save - Saves any changes you made and returns to the Main window.
Cancel - Cancels any changes you made and returns to the Main window.