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Please fill out the following short application. We will contact you by the next business day and let you know if you qualify. This is a free service and there is no cost or obligation.

Sorry, we can accept only U.S. businesses. Gambling or pornographic activities are not accepted.

Please Note: The information you supply will be used only for the purpose of qualifying you for a merchant account by Spectrum Merchant Services. This information you provide is held in strict confidence and is never sold, rented, or shared with any other business or third party.

Company Information
Doing Business As Name Company Legal Name (if different from DBA)
Location Address Mailing/Billing Address (if different from DBA)
City City
Zip Country
Zip Country
Phone Phone
- ext. - ext.
Fax Fax
- -
Web Site Address
E-mail
Merchant Profile
Business Open Date (i.e. 01/01/2000) Expected Annual Sales ($US)
Federal Tax ID Expected Monthly Credit Card Sales ($US)
Type of Goods/Services Sold Average Ticket ($US)

*Hard copy of the merchant processing agreement and application must be submitted after pre-qualification.


©2001-2008 Spectrum Merchant Services. All rights reserved.
Spectrum Merchant Services is a registered ISO/MSP of Wells Fargo Bank, N.A., Walnut Creek, CA.
American Express requires separate approval.