Online Pre-Application

Please complete the form below and we will prepare the final document for you. You will receive an electronic document by email that will allow you to answer a few remaining questions and provide final approval. Once we receive everything back and everything is complete, your account will be submitted and you could be processing in as little as 24 hours!

Business Name (DBA) *

Business Legal Name (If different than dba) *

Business Address, City, State, Zip *

Business Telephone *

Type of Business (IE: RETAIL, RESTAURANT, ONLINE, etc. Please be as detailed as possible) *

How long have you been in business? *

Are you currently accepting credit cards? *

If yes, who are you currently processing credit cards with?

How will you be processing transactions? *

What is your estimated average ticket / sale amount? *

What is the highest dollar amount you would need to accept on a credit card? *

What is your gross estimated monthly business volume? *

How much of your gross estimated monthly volume will be credit card payments? *

How soon do you need to be able to accept credit cards? *

Name *

First

Last

What is the best telephone number to reach you?

What day and time works best for us to call?

E-mail *

Comment or Message *

Phone