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COVID-19 Debiting Survey
» COVID-19 Debiting Survey
Fields Marked with a
*
are required
*
Company Name
Site/Location Name (if applicable)
*
Contact Name
*
Contact Email Address
*
Contact Phone Number
*
What date did you run your debit?
*
Was this for Classes or Members?
Classes
Members
Other
Please select one of the above options.
*
Please detail the debit dates relevant
Additional Comments
*
Debiting Provider
Please Select
DS Full Service
LinksGateway
LinksPay
Other
Please select one of the above options.