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First & Last Name:

Business Name:

Email:

Phone Number:

Address:

City:

State:

Zipcode:

1. In what type of business will the POS system be used?
Liquor or Wine Store
Convenience Store
Supermarket or Grocery
Clothing, Apparel or Footwear
Deli
Dollar Store
Florist/Flower Shop
Chain Store
Gift Shop
Institutional (Education, Goverment, School Cafeteria)
2. Timeframe for this point of sale Purchase?
Asap
0-3 Months
4-6 Months
6 months or longer
Not Sure
3. What additional device(s) will your POS system utilize?
Credit Card / Gift Card Reader
Integrated POS Cameras
Scales
Barcode Scanners
Label Printers
Handheld Inventory Control Devices
4. Please indicate how many of the following POS Components you will need for each of your locations?
Number of POS terminals ? None 1 2 3 4+
5. Please describe in detail any other requirements you may have for you POS system.

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