Business Referral Form

Referral Partner's Name

This is you, the person sending me the informaiton

Referral Partner Email

For our file

Referral Partner's Phone

We prefer a txt number so we can folllow up on progress

Name Of Business You Are Referring

No large chain businesses please. We typically only do 1-5 location businesses. Call me if more.

Address Of Referred Business

Provide as much info as you know

Name & Position Of Decision Person At Referred Busieness

We need a some type of manager, company officer or owner to proceed

Is The Person Expecting Our Call?

Yes, I Spoke To Them

Person I Spoke To Said They Would Tell Them

No, I Only Gathered Information

Referred Busienss Contact Phone

We need a contact number to proceed

Owner/General Manager's Cell Or DirectNumber

This informaiton is very helpful if possible

What Situation Can We Can Help With

Please select from list

Important: What Version?

You may need to ask

How Are Credit Cards Processed?

Magnetic Swipe

Chip Read

Apple Pay or Similer

Not Accepting Cards, See Notes

We Are Seeking Opertunities To Integrate Chip/Contactless Technology. Sometimes we replace existing solutions with better ones.

If POS, Where Are Cards Being Processed?

Card Reader Is Part Of Workstation

Card Reader Sits On Counter/Cash Drawer

Card Reader Is Brought To Table

Card Reader Is Not Part of POS (seperate service)

This Is Payroll Only Help

You Should Ask This Question To Be Sure

Other Helpful Information, Details, Comments