Application for Accepting Credit Cards
Please provide the following contact information
*
Name
*
Business Name
*
Street Address
*
City
*
State/Province
*
Zip/Postal Code
*
Work Phone
*
E-Mail Address
*
Service Provided
Additional information:
Are you currently processing credit card transactions?
Yes
No
Do you need a Credit Card Terminal or Internet Processing?
Terminal
Internet Processing
Software
Please rate your credit on a scale from 1 to 10?
(10 being perfect)
[Please Choose One]
1
2
3
4
5
6
7
8
9
10
What is the legal type of your business?
[Please Choose One]
Corporation
Sole Proprietor
Partnership
Non-Profit
Would you rather buyout or lease your terminal?
Buyout
Lease
Is there any additional information we should know when considering your application to accept credit card transactions?
