SST: Terminal Installation Request

Self Service Terminal

Thank you for your interest in our Self Service Terminals. Please complete this form in order to start the process of generating your Self Service Terminal quote. There are some prerequisites that need to be met before we can generate your quote.
I have a stable and reliable Fibre or ADSL uncapped internet connection with a minimum of 10 Mbps speed:*

YesNo
Warning

Answering 'No' for the above question may result in a hindered experience with the the self service terminals.

You are required to have a permanently connected, stable and reliable internet connection like ADSL or FIBRE with a minimum speed of 10Mb/s. You will NOT be able to continue with this application.

Please contact your internet service provider or inhouse IT department for assistance.

Self Service Terminal

Thank you for your interest in our Self Service Terminals. Please complete this form in order to start the process of generating your Self Service Terminal quote. There are some prerequisites that need to be met before we can generate your quote.
Are you running the Aura POS software?*

YesNo
What POS software are you currently using?*
Is the Aura POS server running Windows 10/11?*

YesNo
Is the kitchen running the new Kitchen Workflow Manager software?*

YesNo

Self Service Terminal

Thank you for your interest in our Self Service Terminals. Please complete this form in order to start the process of generating your Self Service Terminal quote. There are some prerequisites that need to be met before we can generate your quote.
Protection Of Personal Information (POPI)
The personal information you provide on this form will be stored on Jotforms’ servers. It will be used by Cosoft to email your quote to you, phone you to arrange the installation or ask for more information in order for us to quote or to send a technician to your site. It may also be used to SMS you on important progress updates. This information is deleted after 12 months, but a copy of it will continue to exist as a record on Cosoft’s other internal systems. None of this information will ever be shared with a 3rd party unless we need to in order to execute our operations. Examples of this are sharing information with integrators such as your Pinpad service provider or Delivery Tribe for your driver application. Your information will not be sold or shared or used by 3rd parties for the purposes of marketing campaigns.

You can read our full Privacy Policy here: Cosoft Privacy Policy
Owner Details
Owner's Name*

First NameLast Name
Owner's Email Address*
example@example.com
Owner's Phone Number*
Please enter a valid phone number.
Applicant Details

Please fill in if you are NOT the owner
Your Name

First NameLast Name
Your Email
example@example.com
Your Phone Number
Please enter a valid phone number.
Store Details
Brand*
Store Name*
Registered Business Name*
Store's Email*
example@example.com
Store's Phone Number*
Please enter a valid phone number.
Store's Physical Address*
Province*
Province*
RCOE*
Menu Item Type*
Franchise Manager Name*

First NameLast Name
Franchise Manager Email*
example@example.com
Which bank does your store bank with?*
Should be Empty:

Self Service Terminal

Self Service Terminal

Self Service Terminal

Self Service Terminal

Self Service Terminal

Owner Details

Applicant Details

Store Details