Field Feedback Form

1
Agent Full Name* This field is required.
Agent First Name
Agent Last Name
2
Marketing Company* This field is required.
Please Select
Please Select
Adflex F2F
Atomic Sports
Bolt Promotions
Growth Rocket Brisbane
Growth Rocket Perth
Insight Marketing
Invictus Marketing
Ignitions Group
Limitless Enterprises
Stellar Direct
Taylored Sales Group
TMC - Maroochydore
TMC - Sydney
Uniq Impressions - Adelaide
Yield More
DMG
Pride Promotions
Staple Acquisitions
BUA - Melbourne
BUA - Adelaide
Motion Marketing
Fellowship International
3
Date* This field is required.
Date
Day
Month
Year
4
Campaign* This field is required.
Please Select
Please Select
Kiwis for Good
Paralympics Australia
Cerebral Palsy Alliance
Deaf Connect
Royal Life Saving WA - Hybrid
Royal Life Saving WA - Trade Promotion
RSLQ
SLSF
Wheel Chair Rugby NZ
Value Vault
DSA NZ
Scratch & Dent
Brain Injured Children Trust
MS Plus
Royal SA
5
Channel
Please Select
Please Select
Residential
ALT
Shopping Centre
B2B
Tele
6
Agent Email* This field is required.
Your Email
7
Agent Mobile Number* This field is required.
8
Agent Badge Number* This field is required.
9
Location/Site Name* This field is required.
Your Site Location (including full name of shopping centre etc/ or suburb and street name for D2D teams)
10
Type of Situation* This field is required.
Please Select
Please Select
Sales related
WHS/Safety Issue
Potential Vulnerable Customer
Disgruntled Customer
Field Incident
Sales platform issues
Potential Problem
Duplicate/Overcharge
Email Update/Re-send
Community Feedback
Fundraiser Feedback
Other
Adflex Competition
JUICE!
Wrong Payment Method Chosen
Wrong Terminal ID entered
11
Pledge ID/Sale ID or Customer Full Name* This field is required.
Required for sales that have been submitted
12
Your Explanation of events/situation* This field is required.Please include as much information as possible including whether a sale was submitted/ what follow up is needed
13
Upload photo (if necessary)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Submitting this Form will automatically notify Adflex Customer Service and your managing director and admin support team. We will be in contact for further details if need be.
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