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Referral Program
Merchant First Name*
Merchant Last Name*
Merchant Phone Number*
Merchant Industry Type*
Select One
Full-Service Restaurant
Juice and Drink Bar
Fine dining
Quick Service Restaurant
Wine, Liquor and Beer
Partner E-mail*
Partner Contacts*
Please give us more information about your lead below. The more
details you provide, the more equipped we are to close the prospect:
What is the best time of day to contact the merchant?*
Select One
Morning (9am - 12pm)
Mid-day (12pm - 4pm)
Evening (4pm - 8pm)
Is this a new or existing business?*
Select One
New
Existing
Do they already use your services?*
Select One
Yes
No
If existing, what POS System do they use?*
Select One
Electronic Cash Register
PC Based POS
Tablet POS
None
When is your merchant interested in starting with Aptito?*
Notes
Do you agree to the following
Terms and Conditions
?*
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