Rev-share Application -

8:00am-4:30pm Central

Revenue Share Application

Name *

First

Last

Email *

Location Name

Full Address *

Owner Phone Number *

Location Phone Number *

Are Network Drops Preinstalled at Game Bank Locations? *

Are Network Drops Labeled, Terminated, & Tested at Each End?

Name of Internet Provider *

Internet Provider Account Number *

Please Provide all Static Ip Information (static ip range, subnet, gateway ip, dns1, & dns2) *

Amp Rating of Each Dedicated Circuit Breaker *

Is Power Provided at POS/ Guest Services Area? *

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