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MERCHANT ACCOUNT APPLICATION & FREE RATE QUOTE FORM

Request A Merchant Account Rate Quote Online... And Apply Online!

Complete this form if you would like to begin accepting credit cards. After providing us with basic information about your business you will receive a FREE Rate Quote Online and the opportunity to review our application and service agreement. After viewing our online quote you can either apply online for a merchant account or speak to a sales agent if you require additional information. With our automated approval system you can be setup to accept credit cards as soon as today!

If you already own your own credit card equipment we can reprogram most existing equipment after your new merchant account has been setup.

Note that fields marked with an * are required.
  Legal Business Name: *
  First and Last Name: *
  Location Of Business: *
  Telephone #: *
  E-mail: *
  Fax #: (If applicable)

Monthly Estimated Sales Volume (Visa MasterCard Sales "Please estimate") *
  High Volume or Multiple Locations ($100,000 and above)
Low To Medium Volume ($0 - $100,000)
Don't Know (Select this if your not sure.)
  Retail/Wholesale
Internet/Ecommerce
Mail Order/Phone Order
Restaurant
B2B
Wireless
How Would You Prefer To Receive Your Free Rate Quote?
  Online Access (Approval through our automated approval system)
Fax (Documents sent by fax) Much slower approval process
Have A Merchant Account Advisor Call Me
 
  
Completing this form is the fastest way to get started accepting credit cards. An agent may also contact you to complete the approval process. "You are under no obligation by completing the form"

Privacy Statement: We are committed to protecting your privacy. We will not rent, sell or share any information about you with any third parties nor use any personal information for purposes other than answering your inquiries on our products, services and notifying you about offers only from us.

© 2010 CREDIT CARD MARKETING CENTER LLC. All rights reserved.

Services by Cardservice International

The FIRST DATA name, trademark and logo are owned by First Data Corporation. All other trademarks, service marks and trade names referenced in this material are the property of their respective owners. The First Data Independent Sales Agent Program is operated by Cardservice International, Inc. Cardservice International, doing business as First Data Independent Sales (FDIS), is a registered ISO/MSP of Wells Fargo Bank, N.A., Walnut Creek, CA. American Express requires separate approval. FDIS Agent#20264 is an independent agent for Cardservice International.

*Promotional offers brought to you by
Credit Card Marketing Center L.L.C. Restrictions apply, please call for more details