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Please complete the merchant
account "Custom Quote" form below. A merchant
service specialist will contact you within 24 hours
to answer your questions and help you get started.
Or call us toll free
for immediate assistance:
1-800-974-1557
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| Your
Contact Information
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| Your Name:
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| Company Name:
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| Email:
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| Address:
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| City:
State:
Zip:
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| Website Address:
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| Phone Number:
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| Fax Number:
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| Cell Phone Number:
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| Best time to reach you:
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| Preferred
Contact Method: |
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email
telephone
cell phone
fax
postal
any |
| Does
your business currently accept credit cards? |
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Yes
No |
| If
yes, what company currently handles your processing? |
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| What
type of processing methods will you employ? ** hold
down Ctrl key to make multiple selections |
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| Type
of Products or Services you provide (100 words or less) |
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| Anticipated
Monthly Visa/Mastercard Volume |
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Under $5,000/month |
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$5,000 - $10,000/month |
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$10,000 - 25,000/month |
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$25,000 - 50,000/month |
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$50,000 - $100,000/month |
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$100,000 - $200,000/month |
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$200,000 - $300,000/month |
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$300,000 - $500,000/month |
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$500,000 - $600,000/month |
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$600,000 - $750,000/month |
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$750,000 - $1,000,000/month |
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$1,000,000 + per month |
| Anticipated
Average Individual Sale - example: 45.00 (fourty
five dollars) |
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| What
types of services do you currently use? **
hold down Ctrl key to make multiple selections |
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| When
do you anticipate needing your merchant account? |
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| Additional
Comments or Questions |
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| If
you have a Promo Code, please enter it below |
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| Please
make sure you have filled out all fields before clicking
submit |
Advanced
Merchant Group is a registered ISO / MSP of BancorpSouth
Bank, Tupelo, MS. American
Express and Discover require separate approval.
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