Smart Wash Payment Terminal Pre-Order Registration
Please complete the following form to pre order your new 4G and Wi-Fi contactless payment terminal. Product will be available from end of May.
Pipedrive label
Name
*
First Name
Last Name
Company Name
*
Email Address
*
Number of Terminals
*
How many terminals would you like to pre order ($395 excluding GST)
Number of Installation Kits (required for every installed terminal)
*
$129 excluding GST
Are you a current Quest CT400 customer?
*
Yes
No
Terms & Conditions
*
By selecting this checkbox, I give Quest Payment Systems authorization to reserve an order for the Smart Wash Payment Terminal. A deposit of $95 excluding GST per device is mandatory to secure the order.
Authorised Signature
Signature
*
Signing Date
-
Day
-
Month
Year
Date
Place Order
Place Order
Should be Empty: