</' + 'script>'); }

Application

You're just a few steps away from accepting credit cards with your brand new, FREE Hypercom T4100 Terminal!

Stop losing sales because you don't accept credit cards... With our NO OBLIGATION merchant account application, you could be accepting credit cards within 3 to 5 business days. Please complete the form below and a merchant account executive will contact you shortly to walk you through the simple and easy process.

If you have any questions please call us toll free at:
1-877-500-7445

Note: -- This pre-application is for
             U.S. Based Businesses Only.

         -- All required questions are marked
             with a *.

Total Merchant Success Pre-Application:

Does your business currently accept credit cards?

	Yes
	No

Are you currently in need of credit card processing equipment or an online gateway?

	Yes
	No
	Not Sure

How soon are you wanting a merchant account?

	As soon as possible
	1 Week
	1 Month
	I only want information

What is, or do you anticipate, the average individual charge amount per sale to be?

	$1 - $50/per sale
	$50 - $100/per sale
	$100 - $500/per sale
	$500 - $1,000/per sale
	$1,000-$5,000/per sale
	$5,000 + per sale

How much do you currently accept, or do you anticipate accepting, in monthly charges?

	Under $5,000/month
	$5,000 - $10,000/mo.
	$10,000 - $20,000/mo.
	$20,000 - $40,000/mo.
	$40,000-$100,000/mo.
	Over $100,000/mo.

What is your most likely method for accepting credit cards?

	Manually swipe cards at a retail store
	Through a website or online business
	By phone or through mail order
	Manually swipe cards at mobile bus./trade
	Other

First Name:

Last Name:

Email Address:

Home Phone:

Cell/Mobile Phone:

Best time to call:

	Morning
	Afternoon
	Evening

Business Name:

Business Phone:

Business Address:

City:

State:

Zip or Postal Code:

Total Merchant Success
1-877-500-7445