Name

Company

Company Address

State

Zipcode

Phone Number

Email Address

what type of business will this point of sale system be used in?

Bar/Night Club
Quick Service Restaurant (Fast Food, Cafe, etc)
Full Service Restaurant
Fine Dining Restaurant
Other

Is this request for a new system or an upgrade of a current point of sale system?

New system
Upgrade/Replacement

Would your company be interested in the benifets of having a maintenance or service contract?

Yes
No

What is your estimated timeframe for implementing a Point-of-Sale solution?

Immiediatly
1 - 3 Months
4 -6 Months
7+ Months

Please place any comments or questions in the box below.