ATM Fast Approval Form

Please fill in all fields that apply
We do not share or sell your information

Your Name
Business Name
Type of Business
Location Telephone
Cell / Mobile Number
Email Address
Type of Free Placement Cashless Cash
Store Number
Daily Customer Foot Traffic
Days & Hours Open
Average Check
Monthly Sales
Distance to Nearest ATM

For Hotels - Please Answer the Following:

No. of Rooms
Full Service
Type of Location
Business Street Address
Chain? Yes
Corp. Name:
How Many Locations? 
Interested in Free Placement   Purchase  
Lease   Processing Only
Questions / Comments
How were your referred?


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