Pre Credit Card Processing Form

Currently we accept most all merchants for credit card processing. Specializing in High Risk Merchant Credit Card procesing.

If you are interested in the program above please fill out the form below to take the next step or call Ron at 312 212 3711.

First Name (required)

Last Name (required)

Email (required)

Phone

Fax

Nature of Business (ie Restauant, Laundromat etc) (required)

Is the business Retail, Online or Both (required)

 Retail Online Retail/Online

Estimated Average Ticket (ie $50.00 per ticket charge)

Estimated Sales per month

Is this an Existing or New Business (required)
 New Businesss Existing

If Existing Business, how many years

Personal Credit Score - State Score or state Great, Average or Bad (required)

Do you currently have a credit card processing acccount (required)

Comment or additional info