- B-Konnected

Name

First

Last

Email

Phone Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Number of Units

Number of Units that will be surveyed. *If you are choosing “Prime” and you have over 1000 units then you will be charged the additional fees per unit via your payment option. If you are choosing “Premium” and have over 3000 units then you will be charged the additional fees per unit via your payment option.*

Website / URL

This will be utilized to allow new residents to apply for your location.

to Bank Number

Logo Upload

Click or drag files to this area to upload. You can upload up to 2 files.

This will be utilized to be on our public facing website and other documents. *By submitting this image (or images) you are giving permission to allow B-Konnected, LLC to use these images.*

Image Upload

Click or drag files to this area to upload. You can upload up to 10 files.

This is to upload images of your building or location that will be utilized to be on our public facing website. *By submitting this image (or images) you are giving permission to allow B-Konnected, LLC to use these images.*

Comment or Message

Pricing Options

Prime (Annual Fee for Up to 1000 Units Included) – $4,000.00
Premier (Annual Fee for Up to 3000 Units) – $7,500.00

Add-Ons

Momentum Package – $2,800.00
Data Collection Kiosks Set Up Fee (First Monthly Fee to be Automatically Charged When Number of Kiosks is Determined) – $850.00
Data Collection in Person Engagements – $2,500.00

Additional Fee for Units over 1000 (Prime)

Price: $0.00

$4 Per Unit over 1000

Additional Fee for Units over 3000 (Premier)

Price: $0.00

$6 Per Unit over 3000

Subtotal

Price: $0.00

Payment Options

Credit Card
ACH

Credit Card Fee

Price: $0.00

Total Amount Due

Price: $0.00

Includes all pricing and fees.

Stripe Credit Card

ACH Payment Information

In order to process your ACH payment for your Resident Success™ purchase, we ask that you provide the following below information. Please note that this payment may take 3-5 business days to show up in your account.

Bank Account Number

Routing Number

By checking this box you have read and agree to the Terms and Conditions.

By checking this box you acknowledge you have read and agree to the Terms and Conditions & Privacy Policy.

Custom Captcha

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RESIDENT SUCCESS™ PAYMENT FORM

ACH Payment Information