New Merchant's Enrollment Form
LEGAL BUSINESS NAME:
*
CONTACT INFORMATION
*
First Name
Last Name
PHONE NUMBER
*
-
Area Code
Phone Number
EMAIL
*
example@example.com
NUMBER OF LOCATIONS
*
1
2
3
4
5
6
7
8
9
10
WEBSITE
*
GROSS ANNUAL SALES
*
WHAT IS THE AVERAGE PRICE OF YOUR SALES
*
MONTHLY AVERAGE QUANTITY OF CREDIT APPLICATIONS
*
WHICH COMPANIES/BANKS ARE FINANCING YOUR BUYERS'S CREDIT APPLICATIONS? (please list all lenders, primary and secondary, if any
*
Submit
Should be Empty: