Application to Add QikKids Payments to Existing QikKids Database

This application is for clients who wish to add QikKids Payments to their existing QikKids database.

COMPANY DETAILS

Company/Group name*

Street*

Suburb*

State*

Postcode*

PRIMARY CONTACT DETAILS *
(PLEASE MAKE SURE YOU HAVE THE AUTHORITY TO REQUEST THIS CHANGE)

PRIMARY CONTACT DETAILS*

First Name * Last Name *

Email Address*

Phone Number (incl. Area Code)*

SECONDARY CONTACT DETAILS

SECONDARY CONTACT POINT

First Name Last Name

Email Address

Phone Number (incl. Area Code)

EXISTING DATABASE DETAILS

Current Database Name*

Support ID of 1 service on database*

QIKKIDS PAYMENTS Log In Details

QikKids Payments username (Enter email address of primary user)*

QikKids Payments password*

QikKids Payments password Re-enter QikKids Payments password

Strength indicator

To make password stronger, use upper and lower case letters, numbers and symbols like ! " ? $ % ^ &

Debitsuccess services*

Credit Card payments
Direct Debit Payments
BPay Payments - Standard
BPay Payments - Sub-biller

Payment for QikKids payments transactions charged by QK Technologies is via Direct Debit only. QikPay service incurs charges in addition to the standard QikKids Support licensing fees. 16.5 cents per transaction will be charged by QK Technologies to your Company. Note that these charges do not include costs by Debitsuccess in managing the DD/CC/BPay transaction. Please contact Debitsuccess for this information.

Accept Order confirmation and notes*

Do you already have a Direct Debit arrangement with QK Technologies?*

Yes
No

Payment for QikPay transactions is via direct debit only

CAPTCHA

COMPANY DETAILS

PRIMARY CONTACT DETAILS * (PLEASE MAKE SURE YOU HAVE THE AUTHORITY TO REQUEST THIS CHANGE)

SECONDARY CONTACT DETAILS

EXISTING DATABASE DETAILS

QIKKIDS PAYMENTS Log In Details

PRIMARY CONTACT DETAILS *
(PLEASE MAKE SURE YOU HAVE THE AUTHORITY TO REQUEST THIS CHANGE)