Request for Credit Card Merchant Account

The following form will directly notify a ManageMore approved Merchant Account Provider for obtaining a credit card merchant account.  The Merchant Account Provider guarantees that you will not be charged any application fees, not be locked into any contract terms, and will be under no obligation to accept a credit card merchant account, if approved.

Please fill out this form as completely as possible. The Merchant Account Provider should contact you within 2 business days to get further information about your business model, credit amount desired, payment methods you want to accept, etc.

Owner's Name:  Mr.  Ms.  Dr.


Contact Name, If Different:

Business Name:

City: State:


Best Phone Number To Reach Applicant:     (REQUIRED)

Your Email Address:

Your World Wide Web Address (If Applicable):


What type of card processing are you looking for (check all that apply):


Please Feel Free to Send Any Comments You May Have.

For verification reasons, please type the following characters
in the space provided : Z8MM1                         (REQUIRED)