Site Information If directed by your consultant, please fill in the form below with your custom site information: Name Site Information Trading Name * Street Address * Suburb * State * Postcode * Main Phone Number * Payment Method FreeTrial 2 Month Sample (Free Trial) Customers may request a 2-month trial that samples what Monit has to offer. Please DON’T check this box if you want to get started with the full Monit system. Select your payment method: PaymentMethod BPAY Credit Card Capricorn Direct Debit Number of Employees at this site * 10+ Include full-time, part-time and semi-permanent staff Person in Charge This person is ultimately responsible for the site Name * Email * Mobile Number * Accounts Contact For billing and other administration Accounts Name Accounts Email * Accounts Phone Number WHS Contact This person will receive and complete the tasks to do each month WHS Name * WHS Email * WHS Mobile Number * Is this the person who will be trained? YesNo Warehouse Facility Please fill in warehouse information if relevant Is there a warehouse facility on this site? YesNo
