Site Requirement Checklist- Indoor

Site Requirement Checklist - Self Order Kiosk
Company Name
Site Contact Name

First NameLast Name
Best Contact Phone #
Please enter a valid phone number.Format: (000) 000-0000.
General Contractor Name

First NameLast Name
General Contractor Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Store/Restaurant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Target Installation Date

MonthDayYear
Date
PLEASE NOTE- AS A STANDARD, WE REQUIRE A MINIMUM OF 2 WEEKS TO COORDINATE YOUR INSTALLATION ONCE YOUR MERCHANDISE HAS BEEN DELIVERED & YOUR INSTALLATION INFRASTRUCTURE IS READY.
Confirm Kiosk install type:

Other
If other, please provide
Photo Requirement #1: Location for Kiosk Install

Please provide photo of where the kiosk will be installed i.e. wall space, counter top or location in store where same will be placed. Measure the designated area for the kiosk, ensuring enough room for customer movement and accessibility. Be guided by the kiosk install guide document you received.
File Upload

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Photo Requirement #2 Electrical/Power Source

We need a photo showing power outlets with respect to kiosk install location.
File Upload

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Photo Requirement #3 Internet Source

We need a photo showing location of internet source: wifi router or ethernet cable connection.
File Upload

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Internet Service Provider
Intended Data Connection
I hereby certify that the information provided on this form is true and correct.
Signature
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Site Requirement Checklist - Self Order Kiosk