BEVERAGE SOLUTIONS Please fill out the form below to share the lead profile with our sales team First Name Last Name Email Business Name Mobile Business Type - Select - Restaurant Quick Service Restaurants On the Street Cafes / Bar Business and Industry Hotel Leisure, Sports and Entertainment Community Travels & Leisure Health Facility Government Education Vending Convenience OOH Contract Catering Coffee to go Other Distributor / Wholesaler 3rd Party Manufacturer Delivery & Dark Kitchen Wholesalers OOH Cash and Carry OOH eCommerce OOH eCommerce Nestlé OOH Job Function - Select - Executive Board Purchasing Manager Sales Manager Head of Personnel Quality Officer Production Manager Personal Assistant IT Manager Financial Account Manager Marketing Manager RD Manager Supervisor Service Support Manager Distributor Sales Representative Sales Account Rep Sales Admin. Manager Business Manager Cost Accounting Manager Audit Manager Tax Manager Statistician Operations Manager Engineer Purchase Specialist International Trade Manager Logistics Manager Consultant Head of Purchasing Head of Sales Janitor Head of the Canteen Owner Administrator Merchandiser Chef Food and Beverage Manager Manager Catering Manager Other Clerk Operations / Supply Chain Product Development / RD Nutritionist Human Resources Dietician TIO Order Head Chef Quality Assurance Franchisee Distributor Sales Rep Broker Sales Rep Barista Street Address City Province - Select - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Do you have a head office? - Select - Yes No Please Specify Is Billing/Contact Information the same as Shipping Information? - Select - Yes No Ship to Name Ship to Business Name Ship to Phone Ship to Email Ship to Address Ship to City Ship to Province Ship to Postal Code Does the customer have existing assets from Nestle Professional? - Select - Yes No Please specify Machine of Choice - Select - Vitality Express (Juice PC3 / PH) Throughput Validation - Select - Yes No Waterline Supply (3/8th compression) - Select - Yes No Electrical Supply - Select - 110V 120V 120/208V Please specify Describe location of installation "Portion Control" or "Push and Hold" Functionality? - Select - Portion Control Push and Hold Menu Details: Confirm Cup Size 8oz 12oz 16oz Menu Description Member of Group Purchasing Organization (GPO)? - Select - Yes No Please specify Distributor Account Number and DC location Requested Installation Date (4-6 wk min) Affinity Account Representative Notes By submitting this form I have read and understand the Privacy Policy and Terms and Conditions. CAPTCHA Math question 9 + 5 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
