Form

Tell us about you and your company:

First name*

Last name*

Email*

Phone number*

Website URL*

Company name*

Please provide the legal name of your company.

Street address*

City*

State/Region*

Postal code*

Requested Product*

Please select the product you are interested in.

Do you have a preferred payment gateway?

If you have a preferred payment gateway, let us know. If not, we can help with that.

Payment Gateway Name

Please provide the name(s) of your preferred payment gateway(s). We will follow up with you to set it up.

General Comments

Please tell us about your use case and what you would like to accomplish.

Development Environment

Check all that apply

Mobile

Web Browser

Other Device

If other, please describe.

Preferred Client ID*

If you have a preferred name for your ID, please provide it - else mark N/A

Application Domain URL*

Please provide a domain or valid URI for your server application that will direct users to Wink inside your app or browser.

Redirect URL(s)*

Please provide a domain or valid URI for your server application that will redirect users from Wink after a successful login in your app or browser. Please be sure to separate multiple entries with a comma. If unknown, then mark N/A.

Localhost Port*

What localhost port do you want authorized, Default is 3000,

Country/Region*

I agree to the Terms and Conditions of the Wink Evaluation License*