Whotspot.com - Order Form

REGISTRATION FORM

Complete the form below based on the information you know.

Upon receipt, we will be able to open a work order to correspond with your online purchase. This will facilitate the programming of your gateway, as well and shipping and contact details.

WHOTSPOT VENUE/PRODUCT REGISTRATION FORM

Where and When did you purchase your equipment

Dealer Name

Date:

Your Information

Customer Name:

Contact:

Address:

City:

Prov/State:

Postal/ZIP Code:

Country:

Telephone:

Fax:

Email*:

Installation Location:

Same as above or:

Address:

City:

Prov/State:

Postal/ZIP Code:

Country:

Telephone:

Fax:

HOTSPOT Directory Listing Information

This is how online search engines will list your location.

Name of Location:

Address:

City:

Prov/State:

Postal/ZIP Code:

Country:

Telephone:

Fax:

Type of Venue:

i.e., cafe, marina, retail...

Internet Connection:

ISP:

IP Config:

Type:		If your ISP assigns you with a Static IP, please specify the details to enable us to pre-program your WiFi Gateway
IP Address:
Subnet Mask:
Gateway IP:
DNS 1:
DNS 2:

Redirect URL:

After a successful login at your Custom Portal Page, your customers will be redirected to a thank-you page. We have a standard thank-you page, or you can select your own URL. This option can be changed later if you currently do not have your own thank-you page.

Standard Thank-you page Custom

Customer has Web Site:

Yes No

Hours of Operation:

Time Zone:

Comments: