Kiosk Hardware - NCR Kiosks and Wholesale Kiosk Systems

PODIUM QUOTATION REQUEST FORM

1. Display:

17" LCD with Resistive TS - Standard

2. Options (Check all that apply):

Integrated WiFi
Magnetic Stripe Reader
Barcode Scanner

3. Application:

What is this Touch PC going to do?:

(Please define your application)

What application software do you plan to use?:

4. Requirements:

Date Needed:

Initial Quantity:

Subsequent Quantity:

Job In-hand    Proposal Only

Preferred Payment Options: Purchase   Lease Rent

How did you hear about us?: Google   Yahoo    Referral

General Information:
Company
Name
Address
City	State/Province Zip/Postal Code
Country (if not U.S.)
Phone #	Fax #
E-mail

Kiosk Mirror Site Kiosk Main Server
Instruments & Equipment Company - 2 Wilson Drive - Unit 1 - Sparta - NJ - 07871

Phone: 973-579-0009 or 800-432-1255 - Fax: 973-579-6665 - email: iekiosk@iepos.com

General Information: