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Contact
"
*
" indicates required fields
Dashboard/Texting Intake Form
Car Wash Name
*
Employee #
*
Password
*
Location
*
ODBC Credentials
Host
*
Port
*
Username
*
Password
*
Path
*
Have these credentials been verified to be working within the past week?
*
Yes
No
Website Address
*
Time Zone
*
America / New York
America / Chicago
America / Denver
America / Los Angeles
What do You Define as Your Week? (Your end of week day through the day before)
*
What Frequency do you Want?
*
Daily @ 7pm
Weekly @ 7pm
Monthly @ 7pm
Specific Hours
What Times Would you Like to Receive Notifications? (eg. 8am, 10am, 2pm)
*
Internal Contact List
How Many People will Receive the Daily/Weekly/Monthly Text Reports?
*
Please enter a number from
1
to
5
.
Contact One
Name
*
Does Contact One Want to Receive Messages via Text, Email, or Both?
*
Text
Email
Both
Email
*
Phone Number
*
Do They Need an Account Created to Access the Dashboard?
Yes
No
Contact Two
Name
*
Does Contact Two Want to Receive Messages via Text, Email, or Both?
*
Text
Email
Both
Email
*
Phone Number
*
Do They Need an Account Created to Access the Dashboard?
Yes
No
Contact Three
Name
*
Does Contact Three Want to Receive Messages via Text, Email, or Both?
*
Text
Email
Both
Email
*
Phone Number
*
Do They Need an Account Created to Access the Dashboard?
Yes
No
Contact Four
Name
*
Does Contact Four Want to Receive Messages via Text, Email, or Both?
*
Text
Email
Both
Email
*
Phone Number
*
Do They Need an Account Created to Access the Dashboard?
Yes
No
Contact Five
Name
*
Does Contact Five Want to Receive Messages via Text, Email, or Both?
*
Text
Email
Both
Email
*
Phone Number
*
Do They Need an Account Created to Access the Dashboard?
Yes
No
Contact
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Name
First
Last
Email
Phone
Company
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First Name
(Required)
Last Name
(Required)
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Phone
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What service(s) are you interested in?
(Select all that apply)
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