Prospay, Inc. - Apply Online

		Call Today		(800) 201-0091

We’re glad you are interested in joining the hundreds of thousands of successful Prospay^®, Inc. merchants who accept credit cards, ATM/debit cards and checks for their customers’ purchases. Prospay, Inc. boasts a high approval rate. Once your merchant account is approved, which usually takes two business days, you will be able to accept credit cards the very next business day.

Complete the merchant inquiry form below, and a Prospay, Inc. representative will contact you within one business day.*

Please call (800) 201-0091 if you have any questions or would like to apply directly over the phone.

*A hard copy of the Merchant Processing Agreement and Application (MPA) must also be submitted for approval.

NOTE: This application is for US-Based Businesses Only.

Merchant Information

Please select which payment methods you would like to accept:	Visa/MasterCardAmerican ExpressDiscover Network TeleCheckOnline Check Svc
Select Business Type: (check all that apply)	InternetRetailMobile/WirelessMail/Telephone Order
Bankcard Estimates:	Combined Estimated Monthly Volume $: Estimated Highest Ticket/Sales Amount $: Typical Ticket/Sales Amount $:
Processing Method: ( Total Processing Method must equal 100% )	Card Swipe% Manually Keyed% Phone/Mail Order% Internet%
Have you ever had a merchant account before?	YESNO
Type of Processing Solution Desired:	Credit Card Terminal Online Processing Gateway/Software Reprogramming for Existing Merchant Account
I Prefer To:	Buy Processing Solution Lease Processing Solution

Business Information

Legal Business Name: *
Business Address: *
City: *
State: *
Zip Code: *
Business Telephone: *
Business Fax:
Email Address: *
URL of the Business (if applicable):
How Long Have You Been In Business?:	Years
Product/Service Being Sold:
Type of Ownership:
Percentage of Ownership in Business:	%

Principal Information

First Name: *
Last Name: *
Residential Address:
City:
State:
Zip Code:
Number of years at this address:
Telephone:
Lead Source:
Comments/Questions:

(* indicates required field)




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