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Need Paper Page
Considering Processing Credit Cards
* - Required fields have an asterisk.
1) Tell us what your company does:

2) Who are your current customers? (check all that apply)
General Public   Government   Business to Business  

3) How would you accept credit cards? (check all that apply)
Swiped via Terminal   Keyed via Terminal  
On-Line Gateway       E-Commerce (Shopping Cart)  

4) Type of Business that you are (check all that apply)
Retail   Restaurant   Mail/Telephone Order   Website/E-Commerce   Lodging/Car Petroleum
Supermarket   Non-Profit  

5) Average $ Sale Amount?

6) Average # of Transactions Monthly?

7) Average $ Processing Volume Monthly?

8) Seasonal Business?
Yes   No

9) Types of cards/payments you would want to accept? (check all that apply)
Visa   MasterCard   Discover   AMEX
Gift Cards   Check Services   Pin-Based Debit  

10) Are there any situations that worry you about accepting Credit Cards?

11) Additional Information:


12) *Company Name:
*Contact Name:
*Contact Phone:
*Contact E-mail:
Enter code as shown
in the image.
 



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