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Pre-Application
Step
1
of
2
50%
Doing Business As" Name
*
Legal Business Name
*
Last Name
*
First Name
*
Email
Contact Phone
*
Business Info
Business Description
*
Business Phone
Website
Legal Business Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Are your Legal and Physical addresses the same?
*
Yes
No
Physical Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Office Location
*
Select One
Home Office
Mobile
Office Building
Retail Storefront
Shopping Center
Office Size
*
Select One
Under 250 square feet
250 - 500 square feet
500 - 2,000 square feet
Over 2,000 square feet
Credit Card Acceptance
How do you accept credit cards?
*
Select One
In Person / In Store (Card Present)
eCommerce/Website (Card not Present)
Phone Order/Virtual Terminal (Card not Present)
Card Present & Card not Present
Estimated Monthly Volume
*
Average Transaction Size
*
Maximum Transaction Size
*
Legal Questions
Legal Structure
*
Select One
C Corporation
S Corporation
LLC/Partnership
Sole Proprietorship
International Entity
TMF/Match
*
Has your company or anyone associated with ownership of the company been placed on TMF/MATCH
Select One
Yes
No
Statement Upload
Please upload your last 3 consecutive months processing statements for our free comparative analysis to take advantage of our "price reduction guarantee" and also to qualify for our "month to month" option with no contracts
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