Iridium Short-Term VAD Setup Form

Complete this form to establish an equipment account to purchase developer kits and transceivers contained in the VAD Agreement

"*" indicates required fields

Unique ID

Date Submitted*

Orders & Shipping

Contact Name (Order Portal)*

First Last

Title*

Email*

Phone*

Small Package Freight Courier*

Account #*

Method*

Contracted for Equipment Purchase of (mark all that apply):

9602/9603 SBD

9523 LBT

9680 Edge

9690 Edge Pro

9640 Edge Solar

9704 Certus

Service Desk

Technical Contact Name*

First Last

Technical Contact Email*

Country of Citizenship*

Invoice & Billing

Contact Name (Invoicing & Billing) #1*

First Last

Title*

Email*

Phone*

Contact Name (Invoicing & Billing) #2*

First Last

Title*

Email*

Phone*

Acknowledgement

Name of Individual Completing Form*

First Last

Email of Individual Completing Form*

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DynamicsID*

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RequestID*

Name

This field is for validation purposes and should be left unchanged.

Iridium Short-Term VAD Setup Form

Company Information

Orders & Shipping

Service DeskPlease specify the individual in your company you would like to have access to submit technical tickets during development. This individual will receive access to the Service Desk.

Invoice & Billing

Acknowledgement

Service Desk