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Application for Turn-Key-Solution


Please complete this orderform to set up your account.
  Business Name:
Last Name:
First Name:
Address:
City, State, Zip:
Country:
U.S. Federal Tax EIN: (or Social Security#, Corp. Business# or Passport#:
Telephone: -
Best Time To Call:
Fax: -
E-mail:
Your URL:

Are You a New or Existing Business? New     Existing
Business Type:
Business Location:
Nature of Business:
How Do You Market Your Business?
Are You Interested in Real-Time Credit Card Processing For: Internet Commerce Store Front Both

Estimate Average Credit Card Transaction:
Estimate Maximum Credit Card Transaction:
Estimate Monthly Credit Card Volume:
Estimate Monthly Credit Card Transactions:

Please answer some questions about your website and ISP. If you don't know the answers, please contact your webmaster or system administrator. These questions are extremely important, as they will help speed your installation.

Web Site Platform If other, please specify:
Webserver Software If other, please specify:
Type of Site If other, please specify:
If you have a purchase site, please answer these questions:





If you have a purchase website, but aren't planning to use a shopping cart because you only have a few items for sale, please list them here, describe them briefly, and tell us the amount you charge for each.
If you have a membership site, please answer these questions:






Questions about your ISP Who is your ISP?

Who is your contact person there?

What is their phone number?

What is their email address?

What is their website address?


How Did You Hear About Us:
Your contact person:
I have read and printed the Terms & Conditions. Yes     No
Notes or Comments:

Thank you for becoming a MerchantOnline customer. We appreciate your business. Please submit this form and you will be contacted by our MerchantOnline Tech Department to establish your account.


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