About your restaurant(s)
Your details
Title
*
Mr.
Mrs.
Miss.
Ms.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Company Name
*
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Timezone
*
Eastern
Central
Mountain
Pacific
Other
Network & Installation details
Do you require assistance to fill in this section?
*
YES
NO
Who should we contact to assist?
Please contact me to clarify
Please contact our network specialist (Please fill in contact info below)
Do you currently have a camera system set up?
*
YES
NO
How many cameras are installed and working?
The cameras are
Analog
IP
Both
What is the make and model of your drive thru headset equipment?
Internet speed upload
Internet speed download
Do you have a dedicated contact managing your network?
*
YES
NO
Name of contact managing your network
First Name
Last Name
Email of contact managing your network
example@example.com
Phone Number of contact managing your network
*
-
Area Code
Phone Number
Restaurant Layout plan & existing camera setup (if applicable)
Browse Files
Cancel
of
User details
How many users do you want to add? (No need to add yourself. You can add up to 3 now and always add more later)
*
User One
Name User One
First Name
Last Name
Email User One
example@example.com
Phone Number User One
*
-
Area Code
Phone Number
User Two
Name User Two
First Name
Last Name
Email User Two
example@example.com
Phone Number User Two
*
-
Area Code
Phone Number
User Three
Name User Three
First Name
Last Name
Email User Three
example@example.com
Phone Number User Three
*
-
Area Code
Phone Number
End of Users section
When you complete this form and click submit a new form will be displayed, please keep filling this form for all the locations where the Hoptix system is intended to be installed. If you don't wish to complete the form again, press submit and close the tab.
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