Merchant Processing Form

Before you proceed,

If your business is not generating more than $75,000 in annual revenue, we may not be the best fit for you.
Merchant Processing Questionnaire
Business Name
Main Contact

First NameLast Name
Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
example@example.com
Current Website URL (if applicable)
How did you hear about us?
What kind of equestrian business do you run? You can choose more than one.

Other
What methods of payments do you currently take? You can choose more than one.

Other
Do you currently use any of the following? You may choose more than one.

Other
What is your average monthly number of transactions?
What is your average transaction amount?
What percentage of your total billing is processed by credit cards?
If applicable, what is your current merchant services provider/processor, and what is the gateway provider?
If you manage horse shows, what software do you use?

Other
Thank you for taking the time to fill out this questionnaire. It will help us determine how best to help you!

We will be reaching out shortly to set up an introductory call, and look forward to the opportunity to work together.

Regards,

Robin Wertleib Schwartz

President

Equestrian Payment Solutions

Email: robin.schwartz@amgpay.com

Cell: (301) 674-7600‬
I prefer a quick phone call. What is the best time to contact you?
Should be Empty:

Merchant Processing Questionnaire