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online merchant applications

Apply For A Merchant Account

Please fill out the short merchant account application form below and one of our experienced merchant account counselors will get back to you to complete the process. The following information will assist us in making the best recommendation for your business.

We will work hard to get you approved for a merchant account today!

 

Business Information

Business Name:
Business Address:
City, State, Zip Code:
Business Phone:
Business Fax:
Web Site Address:
Type of Business:
Business Start Date (MM/YY):
Please describe products or services sold in a few sentences:

Is the business based in the U.S., and does the owner have a U.S. SS#? Yes No
Do you currently process Credit Cards? Yes No
Estimated monthly card sales volume:
Estimated cost per item or services:

Contact Information

Contact Name:
E-mail Address:
Best number to reach you at:
Best time to call:
Time Zone:

Processing Options

Option interested in (check all that apply):

Online Internet Processing
PC Based Software
Point of Sale Terminal
Notes or Comments:

 

Merchant Account Group
23012 Oxford Place
Suite B
Boca Raton, FL 33433
Local: (561) 451-2654
info@merchantaccountgroup.com

© 1999 - 2003 Merchant Account Group. All Rights Reserved.

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