Application Information: 1. How do you receive
most credit card orders?
2.
Which credit cards would you like to accept?
3.
How large is your average credit card sale?
Choose below
$1 - 19
$20 - 49
$50 - 199
$200 - 999
$1,000 - 4,999
$5,000+
4.
What is your current monthly credit card
processing volume?
Choose below
$1 - 2,499
$2,500 - 4,999
$5,000 - 9,999
$10,000 -
24,999
$25,000 -
49,999
$50,000 -
99,999
$100,000 -
249,999
$250,000 -
499,999
$500,000 -
999,999
$1,000,000
- 4,999,999
$5,000,000+
5.
How much do you expect your monthly credit card
processing volume to be in six months?
Choose below
$1 - 2,499
$2,500 - 4,999
$5,000 - 9,999
$10,000 -
24,999
$25,000 -
49,999
$50,000 -
99,999
$100,000 -
249,999
$250,000 -
499,999
$500,000 -
999,999
$1,000,000
- 4,999,999
$5,000,000+
6.
What kind of credit card processing equipment
and other merchant accounts services interest
you?
7.
If you are looking for credit card processing
terminals, how many are you interested in?
Choose below
1
2
3
4 - 9
10 - 19
20 - 29
30 - 49
50+
8.
What is your buying timeframe?
Choose below
ASAP
1-2 weeks
3-4 weeks
1-3 months
3+ months
9.
What is your fax number?
10.
What is the five digit ZIP code for your office
location?
11.
Please describe in detail the products and
services you sell as well as any additional
requirements you may have?
Note: There is a 500
character limit for this answer.
Your Information: