Order Form

Business Legal Name

dba

Number of Corner Bakery Locations

Kiosk Solution (One Solution per Location)

Choose Your Bundle

Wallaby Stand Complete Solution - $421/month* for 36 months

SpacePole Mount Complete Solution - $319/month* for 36 months

Owner's Name

First Name

Last Name

Business Phone

(###)

###

####

Owner's Email Address

for document signing purposes

Business Address

Street Address, City, State & Zip Code

Referred By (Sales Representative)