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Customer service request form
Use this form to forward your request to our Customer Service Department. Unless special maintenance arrangements are in place, this request will be responded to during normal business hours.
Customer details
Contact Name* 
Company* 
Fax 
Date  (dd-mm-yyyy)    Mobile 
Email* 

Type of problem (check which ones apply)





Severity - please select one





Please supply the following information
Products
System Title/ Version
cl Language, Database or Tools 
Customer hosted application
developed by Multibase 
Multibase-hosted application
developed by Multibase 
Other 
Credit card payment gateway 
Date and time that you
must have this resolved by 
Brief Description of the problem
(include example if possible or
email to customerservice@mbase.com.au
or fax at 02 9805 1931) 
Hardware/Platform 
Operating System and Version 


 
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