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Merchant Account Application (Please fill out the online application below) Whether you have a retail storefront, restaurant, hotel, service business, mail/phone order, or e-commerce business, your customers expect you to accept credit cards. Advanced Merchant Services can help you easily set up a merchant account to take credit cards. The entire process will take just minutes of your time and you'll be up and running in a matter of days. FREE online application FREE 2nd day air shipping FREE equipment placement program FREE replacement of broken equipment FREE set-up and training FREE check imager FREE internet gateway for online merchants FREE online access to your merchant account Ready to get started? Fill out the following form and click submit below: OWNERSHIP INFORMATION Owner Name  * Contact Name (If Different) E-mail Address  * Legal Business Name Business Street Address  * (No P.O. boxes - If home-based, please enter home address) City  * State  * Please enter the 2 digit state abbreviation here Business Zip Code  * Business Phone Number  * Fax Number Cell Phone About Your Business and Products Sold Products Sold Estimated Average Credit Card Sale Estimated Credit Card Monthly Volume Web site Address (If applicable) Have You Ever Accepted Credit Cards? No Yes What Kind Of Equipment Or Online System Do You Want To Process Your Credit Card Orders (Note: Banks Now Require Transactions To Be Conducted Electronically - Paper processing Is No Longer Available) Equipment Needs   I have a terminal, I just need a Merchant Account   I want to take Advantage of Package 1. Free Placed Hypercom T4100 with a new merchant account   In addition I want Package 2 and stop my bad check losses with the free placement of a check imager.   I want to take advantage of the Free Nurit 8000 wireless terminal!   FREE Internet payment gateway software. I do not swipe most cards. In addition, Please quote the following Value Added Services Value-Added  Services   Customized Gift / Loyalty Card Program   Electronic Check Conversion Guaranteeing My Checks   FREE Statement Analysis - I need to know if I have the most competitive rates in the Industry!   CASH Advance Program! I need an infusion of CASH (must be retail and have processed credit cards for a minimum of six months) If Applicable, What info didn’t we provide  that you wish we did? Do you want to accept American Express cards? No Yes Do you want to accept Discover cards? No Yes Feel free to tell us what you thought about our site. If you have any additional comments or questions please enter them here. We really appreciate the time you took and the feedback we get. We'd also like to know how you liked our site?