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

Please Note:
This page is SSL protected. The information you supply will be used only for the purpose of qualifying you for a merchant account by Global Virtual Payments Corp and affiliated banks. The information that you provide is held in strict confidence and is never sold, rented, or shared with any other business or third party.

Merchant account application
Company Name:
First Name:
Last Name:
Business Address:
City:
State:
Country:
ZIP:
Phone:
Phone ALT:
E-Mail:
Website name:
Type of business:
If Internet Based Business:
If Phone Order:
Are you shipping a product:	Yes No
Type of Merchant Account needed:
Is this a new business:	Yes No
How long has your company been doing business?
How is your personal credit?
Are you a U.S. based company?	Yes No
To achieve a lower discount rate, can you provide a bank reference?	Yes No
To achieve a lower discount rate, can you provide 2 years of personal or business tax returns?	Yes No
To achieve a lower discount rate, can you provide company financial statements	Yes No
Present Monthly Sales:
Avg. Ticket of Service or Product
Questions/Comments:
Please check the following box to confirm you have read and agreed to the terms and conditions of Global Virtual Payments Corp..	Yes No

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Merchant account application

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