Get Started!
Retail rates as low as 1.18%; Mail Order/Telephone or Internet rates as low as 2.25%. We offer the best service in the industry at the best possible pricing. Don't settle for anything less. We offer 24 hours, 7 day a week customer support through a dedicated toll free number; plus your calls are answered by a live trained representative usually in under one minute! By far the best merchant bank card service in the industry. We will work closely with you to get your web site e-commerce enabled, including a secure payment gateway, encryption, and security tools. We are now including PCI compliance tools at no extra charge!

 No Obligation Worksheet - Get All the Details you need to Start Accepting Credit Cards

Privacy Policy: Your information is confidential - it will not be sold or shared with anyone.

This application is for:
Want to Accept Credit cards Existing Merchant - Better/ More Svcs. Free Pin Pad Free Check Reader

Business Name

E-MAIL Address
(Required!)

Your home page web address, if any

Date Established

Business Telephone

Fax Number

Method of Selling
StoreFront MailOrder Trade Shows Door to Door Internet Only Other

Will you physically obtain the credit card from your customer for you to "swipe" the card?
Yes, I'll usually swipe the card! No, card won't be present

Your business is located in
In the U.S. Outside the U.S. - foreign country

Business Address

City State Zip CHOOSE A COUNTRY USA Afghanistan Albania Algeria Am. Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Ascension Is Australia Austria Azerbaijan Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia Botswana Brazil Brit. Vir. Is. Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canary Islands Canada Cape Verde Is. Cayman Is. Centr. Africa Chad Chile China Christmas Is. Colombia Comoros Congo/Brazzaville Congo, Dem Rep Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Diego Garcia Djibouti Dominica Dominican Rep Ecuador Egypt El Salvador Eq. Guinea Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands Fiji Islands Finland France Fr. Antilles French Guiana Fr. Polynesia Gabon Rep. Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenadines Grenada Guam Guadeloupe Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, South Korea, North Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Is. Mauritania Mauritius Mayotte Is Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Ant Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Island Norfolk Island Northern Mariana Is Norway Oman Pakistan Palau Panama Papua New Gui. Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Is. Romania Russia Rwanda Saipan San Marino Sao Tome Saudi Arabia Senegal Seychelles Is. Sierra Leone Singapore Slovakia Solvenia Solomon Is Somalia South Africa Spain Sri Lanka St. Helena St. Kitts St Lucia St. Pierre/Miq St Vincent Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikstan Tanzania Thailand Togo, Rep of Tonga Trinidad/Tob. Tunisia Turkey Turkmenistan Turks/Caicos Tuvalu Uganda Ukraine U.A.E. United Kingdom USA Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam USVI Wake Island Wallis West Samoa Yemen Yugoslavia Zambia Zimbabwe

Product or Service Sold

Estimated Monthly bankcard volume:
under $1000 $1K - 5K $5K - 10K 10K- 20K 20K - 30K 30K - 50K 50K - 100K over 100K

Average Ticket amount:
under $50 $50 - $100 $100 - $200 $200 - $300 $300 - $500 $500 - $750 $750 - $1,000 $1,000 - $2,000 $2,000 - $3,000 over $3,000

Type of Ownership
Sole Proprietorship Corporation Partnership LLC Non Profit Organization Other

Merchant Location
Shopping Center Home Based Office Separate building Other

Do you
Own Lease Mo. to Mo. Rent

Owners of Officers Information

Principals Name

Title

Home Address

City State Zip

Do you own or rent?
Own Home Rent Home

How long at current address?
less than 1 yr 1 - 2 yrs. 2 - 3 yrs. 3 - 4 yrs. over 4 yrs.

Home Telephone

Personal Credit History
Excellent Good Fair Poor Collections Past Bankruptcy

If past Bankruptcy, how long ago
No bankruptcy - N/A less than 2 yrs. 2 - 3 yrs. 4 - 7 yrs. over 7 yrs.

How did you find our web page?

What search keywords did you use, if any?

Cards you want to accept:

Credit Cards
Discover
American Express
Debit/ATM
Gift Cards

Check Service you want:

Select Check (traditional Check Guarantee)
Electronic Check Conversion (Accept checks just like a credit card!)
Check Authorization Only (not check guarantee)
iChecks Pro (mail/ fax/ internet check processing)

How do you want to process the payments you receive:

Nurit 8000 Wireless Terminal (Credit and Debit Cards)
Mobile 5000 Wireless Terminal (Credit Cards AND Checks!)
Desktop Terminal to Swipe cards and/ or checks (for Retail Stores)
Online Virtual Terminal (for phone or mail orders)
Online Gateway (to connect website store for Real Time authorizations)
Reprogram my existing terminal - Model:
Other (specify):

Development Service:
Web Hosting
Web Design Services

Please Enter the Numberic Value of the Image for Verification:

   
Please be patient. Process may take up to 1 minute.

IF your form submission does not return a page confirmation momentarily, or you get an error, please call 1-800-659-5201. You will receive a special discount for your help. Thank you.

---

E-Commerce | Retail/Storefront | Phone/Mail Order | Get Started