iPad Request Form

iPad Request Form
Name*
Email*
Driver Name*
Driver Email
For Shipping Notifications
Truck #*
Care Of
If shipping to someone other than driver
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Hardware Packages
iPad Mounting Packages

Wi-Fi/Suction Cup Package - Wi-Fi iPad, Arm, Cradle, Suction Cups, Wiring Harness, cable, wall chargerCellular/Suction Cup Package - Cellular iPad, Arm, Cradle, Suction Cups, Wiring Harness, cable, wall chargerWi-Fi/Backing Plate Package - Wi-Fi iPad, Arm, Cradle, Backing Plate, Wiring Harness, cable, wall chargerCellular/Backing Plate Package - Wi-Fi iPad, Arm, Cradle, Backing Plate, Wiring Harness, cable, wall charger
Individual Components
Qty
Current Setup

iPad - Wi-Fi w/ OtterBox caseArm w/ Ball SocketiPad - Cellular w/ OtterBox caseWiring HarnessiPad ChargerBacking PlateiPad CableSuction CupsCradleOther
Older Gen 6 iPads (for trucks with older setup- see below)

Gen 6 iPad (if available)GDS IntelliSkin CaseGDS IntelliSkin CradleGDS IntelliSkin DockOther
Additional Notes/Instructions
Links
iPad Wi-Fi

iPad Cellular
Wall Charger
Cable
iPad Case
Cradle
Arm w/ Ball Socket
Backing Plate
Suction Cups
Wiring Harness
Older Gen 6 iPad hardware
GDS IntelliSkin
GDS IntelliSkin Cradle
GDS IntelliSkin Dock
Should be Empty:

Hardware Packages