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* 1. Business Name

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* 2. Contact Name

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* 3. Email

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* 4. Phone number

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* 5. Business Category

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* 6. Is your business registered and in good standing with the Province of Newfoundland and Labrador?

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* 7. Does your business have any outstanding debts?

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* 8. Do you have proof of all licenses/approvals from Service NL or other government departments based on your product or service offering?

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* 9. Does your business carry insurance in compliance with all applicable provincial or federal laws and also which will specifically cover commercial kiosk operations?

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* 10. Please provide a detailed description of your proposed use of the commercial kiosk, inclusive of the proposed schedule for usage and any pricing charts/menus.

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* 11. Are you able to meet the minimum requirement for operational hours and contractual period outlined in the Terms and Conditions?

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* 12. Please check the box to confirm that you have read the Terms and Conditions.