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Request for Credit/Debit Card Reader/Cash Box
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* Indicates required question
Club/Group Name
*
Your answer
Contact Name
*
Your answer
Contact Email
*
Your answer
Phone Number
*
Your answer
Do you need a card reader? (comes with tablet)
Yes
No
What items (with prices) do you want programmed into the tablet/card reader?
Your answer
Do you need a cash box? (Just box, cash must be requested
HERE
)
Yes
No
Start Date
*
MM
/
DD
/
YYYY
End Date
*
MM
/
DD
/
YYYY
Foundation Fund Name
*
Your answer
Description of Fundraiser
*
Your answer
I understand that if the card reader is not returned within two business days of the completion of our fundraiser, our Foundation fund may be charged a fee to replace the card reader and tablet.
*
I understand
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