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What type of location do you need the ATM (s) installed?
Convenience Store
Gas Station
Retail Store
Restaurant
Bar
Club
Office Building
School/College/University
Other
Approximately what does your average customer spend per visit?
Less then $10
$10-$20
$20+
N/A - Not being installed in business location
Approximately how many people, per day, will visit the location where the ATM will be installed?
Less than 100
100-250
250-500
500+
How many consecutive years has the business been in operation for?
Less than 1
1-3
3-5
5+
N/A
Which “non – cash” forms of payment do you currently accept (please check all that apply)
Checks
Credit Cards
Debit Cards
EBT Cards
Other
Do you currently have any ATM machines installed in this location?
Yes
No
What type of ATM machine are you considering ? (please check all that apply)
Wall Mounted
Counter Top
Free Standing
Other
What is your desired installation time frame for this ATM machine?
ASAP
1-2 months
More then 2 months
What is the ZIP Code for your business location?
Information about your company
Name:
Address:
City/State/Zip:
Phone:
Email:
Please describe any additional details about your business or ATM needs that you feel will allow us to provide you with a more accurate quote?
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