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Please complete and submit the following information and you will be contacted by one of our merchant service professionals.
Please review for accuracy before submission. Fields marked with a * are required.
Contact Information:
*First Name  
*Last Name  
*Business Name  
*City, State, Zip code               
*Phone Number  
Best time to contact


Do you prefer us to contact you by phone or e-mail?  
*How did you hear about us?  
If you have a promo code please enter it.  
Business Information:
*What type of business do you have?  
*What products or services do you offer?  
*Do you currently accept credit cards? yes no
*What kind of credit card processing equipment and other merchant account services interest you?



Terminal with printer

Terminal without printer

Wireless terminal with printer

Software-based processing

Online Processing

Debit/Check Card

Gift/Loyalty Cards

Check Services



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