Crystal Ball Resellers 30 Day Trial Form

Reseller Details
Reseller Company Name
Name of Sales Person
Select which products the customer would like to trial.
(You can select more than one)
- Mobile Track
- Mobile LWP
- Mobile Monitor
- Vehicle Tracking
- Asset Tracking
Customer Details
Company Name
Main Contact
(First Name)
Main Contact
(Last Name)
Main Contacts Email Address
(You should be an authorised signatory)
Main Contacts position within the company
Industry
Address Line 1
City
Post Code
Contact Telephone Number
Company Registration Number
Potential Opportunity (Number of Units)
System User Information
Administrators Name
Administrator's Email
Administrator's Password (minimum of 6 characters)
Mobile Tracking Details
Handset: Make and Model
Operating System
Handset IMEI
Mobile Phone Number
Vehicle Tracking Details
Vehicle Make
Vehicle Model
Vehicle Registration
Preferred Installation Day/s (Mon-Fri)
Preferred Installation Time (9am-5pm)
Mobile Lone Worker Protection Details
Mobile number text alerts should be sent to?
Checking the box confirms the customer has read & accepted our Terms and Conditions
- I agree to the terms and conditions

NOTE: Installation Terms

* A charge will be applied if the de-installation of the tracking unit does not take place within 14 days of the end of the free trial - charge is £299 + VAT. A charge of £50 + VAT will be applied if an install or de-install appointment is missed without reasonable notice (must be within at least 24hrs before the scheduled installation/de-installation).