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. NOTE: If you are not contacted within 2 business days, please contact our sales department.Company InformationManageMore Status* Registered User Evaluating Demo Contact Name* Company Name* City* State*Select your StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPhone*Email* Best Time to ContactAnytime8:00AM-12:00PM12:01PM-3:00PM3:01PM-6:00PM6:00PM-8:00PMOther InformationWhat type of processing do you need?* Credit Card Authorization Debit Card Authorization eCommerce Card Authorization Manual / Keyed-In Authorization For how many stations do you need credit card processing?*Do you use Remote Desktop Services to run ManageMore?* Yes No Not Sure Please describe any additional requirements you have.