JUUCE Venue Qualification Form

JUUCE Venue Qualification Form

Complete this application to determine your eligibility to host a free JUUCE charging kiosk.
Thank you for your interest in hosting a JUUCE charging kiosk! The information you provide will be used to determine if your business qualifies to receive a complimentary charging station. Please complete all required fields below.
Currently installing in: California's Central Valley • Tri-Valley • Bay Area • Sacramento • Gold Country. Is your business located within any of these regions?
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Business Name
Business Address

Street Address

Street Address Line 2
CityStateZip Code
Are you the decision maker for this venue?
Owner/GM's Name

First NameLast Name
Owner/GM's Email
example@example.com
Owner/GM's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What best describes your venue?

Other
How many patrons visit your venue per day?
What is the average dwell time of patrons at your venue?
What are your operational hours?
Do you currently offer charging solutions for you guests?
Do you currently host another charging kiosk at your venue?
Is a standard power outlet available at the desired installation location?
Are you willing to keep the kiosk plugged in and accessible during business hours?
Will you protect JUUCE stations from damage to the best of the Venue's ability?
Are you willing to display 3rd party advertising?
Additional information we should know:
Please contact JUUCE Charging directly at:

(276) 445-8823

venues@juuce.me

Or apply here:

https://gamma.app/docs/JUUCE-Charging-Station-Info-v48xc35yt8t3tqk
Submitting this form permits us to contact you.

Once you apply, we’ll review your venue within 24 hours.

If approved, we’ll schedule a quick phone call and optional on-site assessment, followed by install (at no cost).
Should be Empty: