|
Merchant account application:
Please complete the application below so
that we may provide you with the product
or service you need. This is not a contract,
but an introduction that allows us to service
you.
Note: All bold fields are required.
|
| Business Legal Name: |
|
|
| DBA: |
|
| Email address: |
|
| Street address: |
|
| City: |
|
| State/Province: |
|
| Zip/Postal code: |
|
| Country: |
|
| Years in business: |
|
| Type of Website: |
|
| Web address: |
|
| Description of business:
|
| Average ticket size: |
|
| Estimated monthly volume: |
|
| Can you provide past processing statements:
|
|
|
