diff --git a/forms/codes.rb b/forms/codes.rb
new file mode 100644
index 0000000000000000000000000000000000000000..3169381a886d9857e24a37bbd45721e699a64263
--- /dev/null
+++ b/forms/codes.rb
@@ -0,0 +1,16 @@
+result!
+title "Unused Referral Codes"
+
+instructions(
+	"This code will provide credit equivalent to one month of service " \
+	"to anyone after they sign up and pay: #{@group_code}\n\n" \
+	"These remaining codes are single use and give the person using " \
+	"them a free month of JMP service.\n\nYou will receive credit " \
+	"equivalent to one month of service after someone uses any of your codes " \
+	"and their payment clears."
+)
+
+table(
+	@invites.map { |i| OpenStruct.new(code: i) },
+	code: "Invite Code"
+)