ATM Request Form
Fill out this form if you would like to host a CoinFlip Bitcoin ATM at your location!
CoinFlip is the largest bitcoin ATM operator in the world, with the lowest fees and 24/7 customer service. By hosting an ATM, you are not only providing an additional service to your store but also earning additional income.
CoinFlip handles all services that are related to the ATM, including customer service, cash collections, and any software-related management.
Please fill out this form and we will respond within 24 hours!
* Required
Name of Store
*
Your answer
Address of Store
*
Please be sure to include city, state, and zip code!
Your answer
Hours of operation for Store
*
format: Day - day: time am - time pm, 24/7 if always open
Your answer
Type of Store
*
Gas Station
Convenience Store
Eatery
Other:
Name of Store Owner or Point of Contact
*
Your answer
Phone number / Email for Point of Contact
*
Your answer
Do you have multiple locations?
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Yes
No
How did you hear about CoinFlip Bitcoin ATMs?
*
Word of Mouth
Google
Flyer
Sales Representative
Other:
If you heard about CoinFlip Bitcoin ATMs through a Sales Respresentative, what was their name? If this does not apply to you, type N/A.
*
Your answer
Additional Information
Put down anything you feel CoinFlip should know about your store that isn't listed above!
Your answer
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