Coinamatic Consent Form
*
indicates required
Name:
Email:
Comment:
Name
Email Address
*
Province
Company
City
Organization
First Name
Last Name
Postal Code
First Name
Phone Number
Address
Description
Property Owner/ Building Manager
Building Resident
Other
Interested In
Coin or Card Vended Laundry Equipment
Non-Vended Homestyle Washers and Dryers
Multi-Load Washer-Extractors and Tumblers
Ozone System Laundry Equipment - EcoTex
Parking
Laundry Tips, Special Promotions and Giveaways
