365 Assistance
Network Provider Input Details
General Information
*
Indicates required field
Business Name
ABN
Main Contact
must be present
Main Phone
must be present
Mobile
must be present
Email Address
must be present
Website
Emergency Phone
Other Contact
Other Phone
Service Type
Battery
General Roadside
Tow
General Roadside & Tow
Locksmith
Motorcycle
EV
Vehicle Types
Towing Details
Fees
Service Locations
Street Address
Suburb
can't be blank
State
ACT
NT
NSW
QLD
SA
TAS
VIC
WA
can't be blank
Postcode
can't be blank
Country
can't be blank
Delete
Add Location
Banking Details
Account Name
can't be blank
BSB
can't be blank
Account Number
can't be blank
Insurance Information
Insurance Details
Please upload your scanned insurance documents below.
Insurance document
can't be blank
Delete
Add File
Terms and Conditions
https://www.365roadsideassistance.com.au/365_privacy-919757.html
365_rsa_provider_terms_conditions.pdf
I accept the terms & conditions
must be accepted
Submit
