Customer Order Form Download and print the form here or submit your request digitally below. We have your order! Partner Information + Name: Phone: Email: Company: Customer Information + Name: Phone: Email: Shipping Address: Zip Code: Shipping Address: Company: Business Type: Retail QSR Admissions Other Existing Hardware + POS Terminal Manufacturer, Model, & Operating System: Printer Manufacturer and Model Payment Terminal Model: Scanner Model: Other: Order Hardware (enter total quantity for each) + Terminals: Partner Tech A5 Partner Tech EM310 Self-Checkout Kiosk Cash Drawer Credit Card Machines: Pax A35 Pax A77 Pax A80 Pax A920 Dejavoo QD4 Dejavoo Z11 Printer: SNBC Printer Impact Kitchen Printer Ticket Printer Epson Receipt Printer Zebra Label Printer Scanners: 2D Scanner Orbit Scanner KORONA POS Entry Scanner P-Ranger Ticket and Inventory Scanner P-Ranger Pistol Grip KORONA POS Software Packages + No. of POS Terminals: No. of Integration Tokens: No. of Ticket Entry Gates: No. of Franchisees: Additional Modules: Retail Plus Food Authorized Signature: Submit
