Common Contracts
3 similar Funded Trial Agreement contracts
One Month Funded Trial AgreementFunded Trial Agreement • August 28th, 2020
☐ I-13 Please Select Mount☐ Table Top☐ Floor Stand ☐ I-16 Please Select Mount☐ Table Top☐ Floor Stand ☐ I-110 Keyguards Mount Options ☐ Table Top☐ Floor Stand☐ Wheelchair* *Only one mount can be supplied Head Tracking ☐ Indi 7☐ SC Tablet ☐ SCF 2x2☐ SCF 3x3 ☐ C5 4x3☐ C5 6x4 ☐ Headmouse☐ TrackerPro ☐ SCF 4x4 ☐ C5 7x5 Switches ☐ SCF 5x5☐ SCF 6x6 ☐ C5 8x5☐ C5 8x6 ☐ Buddy Button☐ Microlight If selecting a Wheelchair Mount, please also select a fastener: ☐ Round Tube ☐ Side ClampIf you are not sure which Chair Fastener is needed, please specify wheel chair make and model: ☐ Channel Nut ☐ Permobil
One Month Funded Trial AgreementFunded Trial Agreement • December 10th, 2018
☐ I-12+ Please Select MountTable Top Floor Stand ☐ I-15+ Please Select MountTable Top Floor Stand ☐☐ ☐☐ ☐☐☐ I-110Indi 7 Speech Case ☐☐☐☐☐ Keyguards SCF 2x2 SCF 3x3 SCF 4x4 SCF 5x5 SCF 6x6 ☐☐☐☐☐ C5 4x3 C5 6x4 C5 7x5 C5 8x5 C5 8x6 ☐☐☐ Mount Options Table Top Floor Stand Wheelchair* *Only one mount can be supplied ☐☐ ☐☐ Head Tracking Headmouse TrackerPro Switches Buddy Button Microlight If selecting a Wheelchair Mount, please also select a fastener: ☐ Round Tube ☐ Side Clamp ☐ Channel Nut ☐ Permobil If you are not sure which Chair Fastener is needed, please specify wheel chair make and model:
One Month Funded Trial AgreementFunded Trial Agreement • December 10th, 2018
☐ I-12+ Please Select MountTable Top Floor Stand ☐ I-15+ Please Select MountTable Top Floor Stand ☐☐ ☐☐ ☐☐☐☐ I-110Indi 7 Speech CaseSpeech Case Pro ☐☐☐☐☐ Keyguards SCF 2x2 SCF 3x3 SCF 4x4 SCF 5x5 SCF 6x6 ☐☐☐☐☐ C5 4x3 C5 6x4 C5 7x5 C5 8x5 C5 8x6 ☐☐☐ Mount Options Table Top Floor Stand Wheelchair* *Only one mount can be supplied ☐☐ ☐☐ Head Tracking Headmouse TrackerPro Switches Buddy Button Microlight If selecting a Wheelchair Mount, please also select a fastener: ☐ Round Tube ☐ Side Clamp ☐ Channel Nut ☐ Permobil If you are not sure which Chair Fastener is needed, please specify wheel chair make and model:
