INFORMATION SURVEY
Yes, we would like to receive more information about following machines:
1.Installation
Installation Inside Outside
Machine location Company Conv. Store Other
Number of employees -10
 10-30
 30-50
 50-100
 100-500
 500-1000
 1000+ 
Service Options Purchase Rent Full-service
2.Products and services
Bread vending machine
 Ice machine
 Flower vending machine
 Cold drink machine inside
 Cold drink machine outside
 Hot drink vending machine
 Candy and confection
 Hot and cold food
Popcorn vending machine
 Hamburger vending machine
Coin operated phones
 Cigarette vending machine
Condom vending machine
 Feminine hygiene vending machine
Notes changers
Coin changers
 Full automated convienience stores
 Newspaper vending machine
Video vending machine
Other
3.Personal Information
Company name
Contact Person
E-mail
Phone
Fax
Adress
Postal Code
City
Country