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USA / Canadian Customers   |   Secure Online Product Order Form

 
Buying large arcade machines requires additional information to be shipping properly, due to weight and size factors
      If you prefer, you can place your order via telephone anytime from 6am to 6pm Eastern Time /  [GMT -5:00]
Monday
to Friday by calling us  |  USA / Canada  :  (800) 746-2255  |  International Orders  :  + 561-391-7200
 

Customer Information

( All Questions marked in
RED must be filled out  )
 * All USA / Canada clients who will be shipping their order outside of North America must use our International Order Form

Your Full Name :    

 

Company Name :    

 

   Your Email Address :    

    ◄  IMPORTANT !

   Re-Enter Email Address :    

    ◄  IMPORTANT !

New or Returning BMIGaming Client ?    

 

Working With a BMIGaming Consultant ?    

     ◄  Select  "font color="#910000"> No / Do Not Know " if unknown
Where Will These Product (s) Be Used ?        If Other :  
     Proceed to the Product Order Information Section below    

Product Order Information

( All Questions marked in
RED must be filled out  )

Product 1 Name :           
Product Price :           Optional - Price shown on website today will be charged
Add Product Options (If Needed)  :      
Add Extended Product Warranty ?     
    
  Click here for more information       
 

Please select below either "Free-Play / Non-Coin" for home / recreational use or a Payment Type for pay / commercial use
 Many items come standard with coin operation that can be set for "free-play", but a few items have a small factory charge to install this

Choose Free / Pay Acceptor Option :         
If "Token Operation"  Selected :       Token Size    (Ex : 0.985")     Do You Need To Purchase Tokens?
   If ordering just one product, proceed to Shipping / Contact Information Section below   

Otherwise please enter the details for other products you wish to order in the fields below :
Product 2 Name :        
Product Price :          Optional - Price shown on website today will be charged
Add Product Options ?       
Add Extended Product Warranty ?       
Choose Free / Pay Acceptor Option :       
Product 3 Name :        
Product Price :         Optional - Price shown on website today will be charged
Add Product Options ?       
Add Extended Product Warranty ?       
Choose Free / Pay Acceptor Option :       
Product 4 Name :        
Product Price :         Optional - Price shown on website today will be charged
Add Product Options ?       
Add Extended Product Warranty ?       
Choose Free / Pay Acceptor Option :       
Product 5 Name :        
Product Price :         Optional - Price shown on website today will be charged
Add Product Options ?       
Add Extended Product Warranty ?       
Choose Free / Pay Acceptor Option :       

Buying more than 5 products ?   

 List the exact names of all the additional products    
you want here, and we'll take care of all the rest.    

  Or call us at (800) 746-2255  |  + 561.391.7200     

   
     Proceed to the Shipping / Contact Information Section below    

Shipping / Contact Information

( All Questions marked in
RED must be filled out  )

Shipping Address Line 1 :  

  

Shipping Address Line 2 :  

  

Shipping Address Line 3 :  

  

City / Town :  

   

State / Province :  

   

Country :  

      
Zip / Postal Code :      

 Primary Phone Number :  

       Extension :  
Cell or Alternate Phone # :          Extension :  
 Type of Shipping Requested ?          
Delivery via 18-Wheel Truck OK ?       
Need delivery upstairs or downstairs ?  

   

 Need delivery to back of your location ?      
How did you access our website today ?        
How did you first hear about BMIGaming ?     
    If Above Question Said "Specify" :     

 Special Order Instructions   
  
Special Delivery Requirements, Order Notes    
Special Requests or Gift Recipient Ship Information    

   
       Proceed to the Payment Method Section below      

Payment Method

( All Questions marked in
RED must be filled out  )



 SAVE !!  |  2.00% Instant Order Discount on all USA Home / Residential Orders paid via Personal Check

  * Payment Type :        
Discount /  Coupon Code :       

BMI Internal Use Only :    

  

* An Order Confirmation Email will be sent within 1-2 Business Days (Mon-Fri) to confirm your order, then shortly after, your Sales Invoice, which includes
your total order and shipping costs. If you elected to pay via Check, Bank Wire, PayPal or Bitcoin, instructions on how to make payments will be included.

       Proceed to Credit / Debit Card Information Section below       

 If not paying by credit card, proceed to Final Checkout Section Below

Credit  / Debit Card Information

( All Questions in GREEN must be filled out if paying by credit card )

Because this is a " high dollar " credit card transaction, our card processor require all of the information below.

 Credit / Debit Card Brand :    

    

 Credit / Debit Card Type :    

     

 Name on Card :       
 Credit / Debit Card Number :       
 Expiration Date :    

     

 CVC / CVV2 Number :              What is a CVC / CVV2 number ?
 Billing Phone Number (Yours) :           ◄ Phone number associated with this card

    Check here if your billing address is the same as your shipping address  |  If not, fill out section below 

* IMPORTANT : Due high-dollar online order fraud, if your credit card billing address is not the same as your shipping address,
contact your
credit card provider to add your ship address to your account  |  Failure to do so now can significantly delay your order.

 Credit Card Billing Address 1 :       
 Credit Card Billing Address 2 :       
 City / Town :       
State / Province :       
Country :       
Zip / Postal Code :       
       Proceed to the Final Checkout Section below      

Final Checkout   |   Electronic Order Signature

( All Questions marked in
RED must be filled out  )

TYPE YOUR FULL NAME BELOW

 

   I AGREE TO THE TERMS AND CONDITIONS OF SALE BELOW

DATE  ( MM / DD / YR )

 


 


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Questions ?  USA / CA  :  (800) 746-2255   |   International  :  + 561-391-7200   |   Español  :  + 561-288-4889