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Step #1- Contact Information
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Indicates required field
Did Someone Refer You To Us? Please Let Us know So We Can Say Thanks?
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Name
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First
Last
Business Name
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Email
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Cell Number
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Do You Currently Except Credit Card?
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Yes
No
Business Number
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Business Address
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Line 1
Line 2
City
State
Zip Code
Country
Tell Us About Your Company
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Step #2- Basic Business Information
Average Monthly Credit Card Volume
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Current Processing Company
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Processing Rates Or Fees
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Which Applies To Your Business?
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Retail Location With Physical Card Swipe
Web Or Online Card Payments Accepted
Mobile Swipe Or Card Reader
Not Accepting Cards Yet
Other...
Any Additional Information, Or Other
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Step #3- 2 Consecutive Monthly Processing Reports
Upload File
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Max file size: 20MB
Upload File
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Max file size: 20MB
Upload File
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Max file size: 20MB
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