Call us now at 1-855-933-3729, or fill out the pre-qualification form below and one of our agents will contact you as soon as possible. Merchant Pre-Qualification Requested Days in Arrears*5 Days6 Days7 Days8 Days9 Days10 DaysRequested Reserve*0%5%10%Ownership InformationIf there are more than 3 owners, add them in the Additional Notes section near the bottom of this form.Number of Owners*123More than 3Owner 1 Name*Owner 1 Email* Owner 1 Phone*Owner 2 Name*Owner 2 Email* Owner 2 Phone*Owner 3 Name*Owner 3 Email* Owner 3 Phone*Business InformationPrice Points*Requested Monthly Limit*High Ticket*Average Ticket*Do your business or personal bank accounts have an average balance of AT LEAST $5,000 (or equivalent) during the past three (3) months?*YesNoDo you have any previous processing?*YesNoDo you currently offer wholesale?*YesNoHigh Ticket*Average Ticket*Do you require MOTO (Mail Order Telephone Order) processing?*YesNoWhat percent of total volume?*Do you offer or plan to have an Affiliate program?*YesNoDo you need POS/Card Readers?*YesNoHas the company or owner(s) ever been placed on the TMF/Match File?*YesNoWhy was the company or owner(s) placed on the TMF/Match file?*Website InformationWebsite URLIs the Website Live?YesNoExpected Live DateWebsite PlatformPlease Select...WordPressShopifyWixMagentoOtherOther Platform*Is the website password protected? (this is for viewing your public pages, not for accessing the site's back end)YesNoPassword*Required FilesPlease upload your three (3) most recent Bank Statements and three (3) most recent Processing Statements (if available). Maximum total size: 40 MB Allowed file types: pdf, jpg, jpeg, gif, png Drop files here or Accepted file types: pdf, jpg, jpeg, gif, png. Additional NotesPhoneThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.