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For all your vending needs
Main Menu
How It Works
FREE Machines
Contact
FREE Vending Machine Request Form
Please enable JavaScript in your browser to complete this form.
Company:
*
Name:
*
First
Last
Email:
*
Email
Confirm Email
Phone Number:
Mobile Number:
*
Mobile number is preferable.
Business Address:
*
Suburb:
*
Postcode:
*
Days of Operation:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hours of Operation (Weekdays):
*
Hours of Operation (Weekends):
*
Staff / Contractors / Visitors onsite per day:
*
eg: (10-20 Staff) -- (5-10 Contractors) -- (50-70 Visitors) Per Day.
Type of Business:
*
Floor Level:
*
Where the Vending Machine/s is to be placed.
Access for placement of Vending Machine/s onto location: (ground surfaces, stairs/steps or other obstacles)
*
Is there any uneven ground surfaces, stairs/steps or other obstacles when placing vending machine onto location. Ground Surface Type from Delivery Vehicle to Vending Machine Placement Destination: Gravel/Concrete/Tiles/Carpet. (FOR HEALTH & SAFETY REASONS - ELEVATOR/LIFT ACCESS IS REQUIRED FOR MULTI-LEVEL SITES -- STAIRS ARE NOT ALLOWED).
Vending Machines: Please Select
*
Drink Machine
Snack Machine
Combo Machine (Single Machine - combination of Drinks & Snacks)
Coffee Machine
If you require a separate Drink Machine & Snack Machine then tick both boxes.
Do you require Healthy Food Options:
*
Select your Answer
YES
NO
How many Vending Machines do you require:
*
Do you currently have any existing Vending Machines onsite:
*
Select your Answer
YES
NO
If there is existing Vending Machines onsite, how many Vending Machines are onsite:
*
Answer - NO. (If there is no existing Vending Machines onsite).
If there is existing Vending Machines onsite, please provide contact details of the service provider:
*
Answer - NO. (If there is no existing Vending Machines onsite).
Comment or Message:
Do you allow KOOK Vending to share your details with other Vending Service Providers:
*
Select your Answer
Allow KOOK Vending to share this "FREE Vending Machine Request Form" to other Vending Service Providers.
Not Allow to share details.
If for any reason, if KOOK Vending is unable to provide vending services to your business. By selecting ALLOW, you will be allowing KOOK Vending to forward this "FREE Vending Machine Request Form" to our network of third-party vending service providers to assist in placing a FREE vending machine at your place of business. If you select NOT ALLOW, then your details will not be shared with other vending service providers.
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