Merchant Application

Legal Business Name

Contact Name

Last Name

First Name

Business Address

Address

City

State

Zip

Phone Number and Email Address

Phone

Do you currently accept credit cards?

Yes

swipe cards at a retail location

on the internet through a website or gateway

by phone or mail order

mobile business in need of wireless processing

other

Type of products/services sold

Comments

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MPC respects your privacy and does not collect any information about visitors to our website. Any information submitted voluntarily through the website is held in the sole possession of MPC and is not sold, rented, or shared with any other entity or individual.

Your privacy and confidentiality is of the utmost importance to MPC. For questions regarding this notice please contact Merchant Processing Consultants, 1901 N Roselle Rd Suite 800 Schaumburg, IL 60195 Email: info@mpcbankcard.com Phone: (847) 592-7075 Fax: (866) 842-8327