LOGICIEL INC, Quote Request for Retail

QUOTE REQUEST FOR POINT OF SALES (POS)

Please fill out the form as completely as possible. We will be contacting you shortly with your quote. (*= required information)

Company name:*

Contact first name:*

Contact last name:*

E-mail address:*

Re-Type e-mail:*

Phone number:*

Fax number:

Company Website:

Company Address 1:*

Company Address 2:

City:*

State/Province:*

Zip Code:*

Country:*

Store Description:

Number of Store Locations:*

Accounting System:*

System Configuration:*

Number of cashier stations:*

Peripheral Required:* Dot-Matrix Receipt Printer Thermal Receipt Printer Cash Drawer Barcode Scanner Pole Display Credit Card Processing

Number of Manager Stations:*

Remarks:

Referred By: