Restaurant Name
Contact Name
Restaurant Address
Business Phone
Cell Phone
Email
Type of Restaurant?
Table
Fast Food
Pizza
Modules
Bar
Dine-In
Take-Out
Delivery
Drive Thru
Advanced Ordering/Catering
Number of Servers per shift
Number of Managers per shift
Hours of Operation
Number of Existing Registers or POS
Do you require Kitchen Display Unit
Yes
No
Remote Printer Requirements
Are Credit Cards Accepted
Yes
No
Do you wish to sell and accept gift cards?
Yes
No
Do you wish to run a frequent diner program?
Yes
No
Do you wish to integrate to QuickBooks?
Yes
No
What is your projected time frame for purchase
30-60 Days
60-120 Days
6 Months or More
Current POS-Age of system & Make/Model
Do you have a Website?
No
If so - Address?
Do you need an extra turn of tables during peak times?
Yes
No
Would additional profits be of interest to you?
Yes
Additional comments, Questions or Requirements:
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