ePay Wireless - Referral Instructions When referring your customers to ePay Management, please use one of the following two means:  1. FAX You can fax your referrals to us using the "New Merchant Customer Referral Form". When you initially sign-up for the Dealer Referral program you are sent a welcome kit that contains the "New Merchant Customer Referral Form". The Forms are also available for download in both Adobe PDF and MS Word format here: Referral Form in PDF Referral Form in MS Word Completed forms should be faxed to ePay Management at 1-480-218-7726.  2. ONLINE FORM You can use the following form for submitting your referrals to ePay Wireless: Please make sure the form is filled in with as much of the information as possible. Please complete all of the fields that pertain to your situation. Dealer Code: Prepared By: Business Name: Contact Name: Telephone Number: Alt. Phone Number: Fax Number: Email Address: Address: City: State: Zip Code: Carrier: Nextel Verizon Sprint PCS Cingular/AT&T T-Mobile Alltel If Other, Please List: Description Of Product/Service: Phone Model: Cellular Phone Number: Data Service(s) Ordered?: Yes No Comments: