Customer Reference Request Nomination Form

Customer Reference Request Nomination Form — Form Fields

This sales template includes 10 fields. Nominate satisfied customers to serve as references, case study subjects, or speakers for sales cycles. Free to customize and use on ZenBuild.

• Customer Company Name (text, required)
• Customer Contact Name (text, required)
• Customer Contact Email (email, required)
• Account Manager Name (text, required)
• Reference Type (dropdown selection, required) — options: Phone reference, Written case study, Video testimonial, Conference speaker, Logo usage only
• Customer Satisfaction Level (dropdown selection, required) — options: Extremely satisfied, Very satisfied, Satisfied, Neutral
• Why is this customer a good reference? (long text, required)
• Industry (dropdown selection, required) — options: Technology, Healthcare, Finance, Manufacturing, Retail, Education, Other
• Customer Tenure (years) (text, required)
• Topics Customer Can Speak To (checkboxes, optional) — options: ROI achieved, Implementation experience, Support quality, Product features, Competitive win