SimpleChurch - Giving Kiosk Purchase Form
 
SimpleChurch - Giving Kiosk Purchase Form
TYPE OF KIOSK AND QUANTITY
Floor Stand Kiosk  * 
Table Mount Kiosk  * 
Wall Mount Kiosk  * 
CONTACT INFORMATION
Contact Name  * 
Contact Phone Number  * 
ACCOUNT INFORMATION
Organization URL/Website  * 
Your Email Address  * 

SHIPPING WILL BE BILLED SEPARATE FROM THIS TRANSACTION

There is a monthly maintenance fee of $19/month per kiosk.

SHIPPING INFORMATION
Shipping Address Line 1  * 
Shipping Address Line 2
Shipping City  * 
Shipping State  * 
Shipping Zip  * 
Additional Comments
Total $
 
 
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