Application Form

Company Information

 

Company Name

Company URL

Company registered in

First Name

Last Name

Job Title

Phone

E-mail(*)

Merchant Website Information

 

Processing URLs

Type of Business

Estimated monthly volume

Average ticket

Processed Credit Cards before

/

Average chargeback ratio per month

Do you use any fraud filtering tools?

/

Specify your interest

Complete Processing & Billing Solution
Merchant Account
Gateway Services
Risk Management
Subscriptions Management
Micro payments Aggregation
Royalties (Affiliates) Management
Customer Support tools
Pre Paid / Post Paid Model
Content Upload & Sell
E-Wallet
Other

Additional information

   

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Fields marked with an asterisk (*) are required

 

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