Welcome NEW Business Owners
Beginning to accept credit cards couldn't be easier! Kindly take a few moments to give us some information about your business. One of our experienced account managers will contact you shortly to answer all of your questions and get your new account up and running. You can use the form below or call our New Accounts Center at 1-888-EMS-1190. We are here to serve you weekdays from 9:30 to 5:30 ET.


All fields with an * are required. 		 
Pre-approval/Flyer Code: (if applicable)
Your Name: *
The name of your business:*
Your E-mail Address:
What do you sell?
Which of the following best describes how you do business:
Restaurant (Mark all that apply)
  Sit Down w/table service
Take Out
Delivery
Mobile Business
  Travel to customer
Exhibit at Shows
Mail Order or Phone Order
Internet or E-Commerce
Other
Please provide one or more phone numbers where you can be reached: *
Cell:
xxx-xxx-xxxx
Business:
xxx-xxx-xxxx
Home:
xxx-xxx-xxxx
Other:
xxx-xxx-xxxx
How did you find us?
Current Customer
Previous Purchase

 Referral
Email Newsletter 		Direct Mail - USPS
Search Engine		 Internet
Other

Please Note: Additional or supporting documentation may be required to determine the best possible rates for your type of business. We do not sell your information in any way nor contact you for any reason other than establishing a merchant account. Your information remains confidential. V01 12/08

Looking for More Information - View Our Website
or CALL TOLL FREE 1-888-EMS-1190
We are here to serve you weekdays from 9:30AM to 5:30PM ET