Merchant Account Application

1
Type of Business* This field is required.
Restaurant/Cafe
Commercial/Cloud Kitchen
Grocery / Butcher / Fruit & Veg
Bakery / Cake Maker
Other
2
Trading Name* This field is required.Name of Venue
3
Contact Person* This field is required.
First Name
Last Name
4
Contact Number* This field is required.
5
Email* This field is required.
example@example.com
6
Address of Business* This field is required.Email additional locations if applicable
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
7
What POS system do you currently use?* This field is required.
8
What is your current weekly volume for deliveries?* This field is required.
9
When do you want to start service?* This field is required.
Date
Year
Month
Day
10
Who referred you to us?* This field is required.
11
Application Fee* This field is required.
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
GSTAUD
SubtotalAUD
Total costAUD
Account Opening Fee
$199.00AUD+
Back
Total cost $0.00AUD
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
12
Invoice ID
Should be Empty: