POS Leads

POS Lead Submissions

Please Note: For Pay-By-Phone (IVR) submissions, Click Here

Unique ID*

Agent Name *

Agent E-mail*

Business Name *

Contact Name *

Phone Number*

E-mail *

Location (City & State)*

Business Type*

Restaurant (Fine Dining) QSR Retail Shul

For IVR submissions, please refer to the message in red above.

Please Choose*

Clothing Store Shoe Store Household/Hardware Accessories Super Market Pharmacy Other:

Please Choose*

Coffee & Bagel Bakery Deli Pizza Shop

Other Business Type:*

Pharmacy*

Retail (Inventory) FSA - SIGIS cards Prescription Related Software Other

Is merchant interested or has been introduced to any of the following POS:*

Amount of stations merchant will use:*

Current POS Status*

No POS System Has POS System

Current POS System Name:

Reason for New POS Change (2-3 examples):*

Additional Information: