Duplicated: Merchant Signup – [#10379]

Full Name(Required)

First Last

Phone(Required)

Email(Required)

When would you like to complete your signup form:

I would like an agent to contact me

I would like to complete my application online, now

Please select which services you are interested in

In-Store Card Processing

Zero Fee Processing / Cash Discounting

Online Ecommerce Gateway

Virtual Terminal

Merchant Cash Advance

Point of Sale

Other

Would you like your Card Machine to be integrated with a POS?

Yes, I would like to integrate with my current pos system

Yes, I would like to integrate with a new POS system

No thanks

What POS are you currently using?

Would you like your Zero Fee Card Machine to be integrated with a POS?

Yes, I would like to integrate with my current pos system

Yes, I would like to integrate with a new POS system

No thanks

What POS are you currently using?

What ecommerce system are you wanting to integrate with?(Required)

Are you looking for a specific POS brand?(Required)

Business Legal Name

Business DBA Name

Type of Business

Tax ID

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Average Ticket Size

Average ticket size is the amount of money that each buyer spends on average

Gross Monthly Turnover

Total amount of money that is / will be processed through your credit card machine

I don’t have this information, please call me to discuss

Business Owner Information

First Last

Phone

Ownership Percentage

Date of Birth

MM slash DD slash YYYY

Social Security Number

Is your residential address the same as your business?

Yes

Residential Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Thank you for your interest to signup, An Agent wil contact you soon.