Please fill in all fields marked with a *
	Title	Mr. Ms. Mrs. *
	First Name	*
	Last Name	*
	Business Name
	Your relationship with the business	Owner Manager Staff Outside Co *
	Street Address	*
	City	*
	State Province etc	*
	Postal Code	*
	Country	*
	Telephone Land Line	*
	Email	*
	Accounting Software Needed
	POS Software In Quote	*
	Number of sales stations	*
	Network to back office	Yes No *
	Number computers needed	*
	Credit card authorization method	My existing terminal Within POS Software Software outside POS Software NA *
	Do you want remote access software	Yes No *
	Type credit card reader	In Keyboard Separate My Terminal NA *
	Do you want a UPS backup	Yes No *
	Do you want a programmable keyboard	Yes No *
	Do you want a report printer	Ink Jet Laser None *
	Type receipt printer	Impact Thermal NA *
	Quantity of Monitors	*
	Type monitors	CRT Touch LCD Touch Non Touch NA *
	Do you want a data collector	Yes No *
	Type Cash Drawers	Platform Standard Separate With CPU NA *
	Type Pole Displays	Table Pole NA *
	Number of stores in quote	*
	What do you sell	*
	What is your budget	*
	Who will install	I will You will Local Guru NA *
	When will you make your purchase	*
	When do you need your quote	*
	What shipping speed do you want	*
	Have you had a PC Based POS system before	Yes No *
	Any additional comments	*