Sign-Up Form

Sign-up Form

By invitation only.

Customer Details

Legal Name:

Trading As:

ABN:

ACN:

Date of Registration:

Business Type:

If publicly listed, ASX code?

If subsidiary, holding company details:

Street Address:

Postal Code:

Billing Address:

Postal Code:

Primary Contact

Name:

Position:

Email Address:

Phone:

Billing Contact
(the person invoices will be sent to)

Name:

Position:

Email Address:

Phone:

Pricing Plan

Scratchie Administration Fee:20% of the money deposited into the Customer Wallet

Bonus Prize Allocation:1% of the money deposited into the Customer Wallet

Monthly Maintenance and Support Fees:NIL

Maintenance and Support Services

Up to 8 Hours of initial training with the Certified Party on how to use the Application

Commencement Date

Commencement Date:

This Subscription Plan is to be read in conjunction with the Terms and Conditions found at www.scratchie.com. This is an offer and this offer is open for acceptance for 30 days. I/We hereby accept this Subscription Plan and agree to the Terms and Conditions.

Full Names (in BLOCK LETTERS)

Dated:

I have read and understand the terms and conditions associated with the use of the Scratchie app and associated services:

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Sign-up Form

By invitation only.

About Us