• This application is for clients who wish to add Kiosk to their database.

    COMPANY DETAILS
    Company/Group name
  • PRIMARY CONTACT DETAILS *
    (PLEASE MAKE SURE YOU HAVE THE AUTHORITY TO REQUEST THIS CHANGE)
  • SECONDARY CONTACT DETAILS
    (PLEASE MAKE SURE YOU HAVE THE AUTHORITY TO REQUEST THIS CHANGE)
  • EXISTING DATABASE DETAILS
  • Interested in getting Kiosk Hardware? (iPad, Kiosk Stand, Site specific configuration  $855 excl. GST) 
    CLICK HERE to complete a form to arrange your hardware order. Please note this is separate to this Kiosk software order.