Information Request
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Company Name
*
Site Location Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of people onsite?
*
Do you hold Regional Meetings at this location?
*
Yes
No
Do you have walk-in traffic?
*
Yes
No
Does walk-in traffic have access to the machines?
*
Yes
No
Is the environment climate controlled?
*
Yes
No
Type of services needed?
*
Food Vending
Drink Vending
Coffee Vending
Snack Vending
Water line present?
*
Yes
No
Hours of Operation?
*
M-F 8 to 5 / 24 hours
Days of the week your open?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Does the location have multiple electrical outlets behind where machines would be placed?
*
Yes
No
Can you get a cellular signal from the desired machine location?
*
Yes
No
Do you currently have vending services onsite?
*
Yes
No
Who is your current Vending Supplier?
How many machines do you currently have?
*
How many machines do you need?
*
What types of machines do you have?
*
Snack Machine
Drink Machine
Food Machine
Combo Machine
Coffee Machine
Are there any difficulties delivering Vending machines to the desired location?
*
Stairs
Elevator
Ground Level Receiving
Dock Level Receiving
Other
Servicing Protocol
*
Specific Time of Day
Security Check Point
Badge / Code Required
COVID-19 Temperature Screening
Protective Eye Ware
Other
Is there security at the location?
*
Cameras / Security Badge requirements
Anything else you would like to add?
*
How did you hear about us?
*
Google Search
Email Blast
Chamber of Commerce
Word of Mouth
Other
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