POS Kiosk Subscription Change Request Form
Please complete this form to request a change to your POS kiosk subscription. All fields are required for timely processing.
Business Name
*
Contact Person Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Kiosk Location or ID
*
Current Subscription Plan
*
Please Select
Basic
Standard
Premium
Enterprise
Other
Requested Change
*
Upgrade Plan
Downgrade Plan
Pause Subscription
Cancel Subscription
Other
New Subscription Plan (if applicable)
Please Select
Basic
Standard
Premium
Enterprise
Other
Requested Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Subscription Change
*
Additional Comments or Instructions
Submit Request
Should be Empty: