Travel Industry Merchant Application

*Company Name:

Company legal name or registered name.

*DBA Name (if
different):

*Business Type:

Or:

*Company Address:

Company Address - Physical Address or main office.

*City:

City

*State ( US Only ):

State - If US Only

*Canadian Province:

Canadian Provine - Canadian Only.

*Province or District
( Non-US or CA ):

Province or District - For all non-US or Canadian Merchants.

*Postal Zip Code:

Postal or Zip Code

*Website URL:

URL of Website: http://www.YourDomain.com


	Company Profile

*Date Business
Established:

/ /	Date the business was started / Registered.

*Business Description:

(chars left: 200)

Business Description: Day to day operations and proceedures - main products or services.

*Marketing and
Promotion Methods::

(chars left: 200)

Describe the marketing and promotional methods used to advertise your business - a.e. newspaper, inbount telemarketing, yellow pages, ect...

*Customer Service:

(chars left: 50)

Describe how your customer service works when contacted for help or support.

*Refund /
Cancellation Policy:

(chars left: 200)

Describe your Refund & Cancellation Policy.


	Risk Assessment Profile

*Average Ticket:

$	Average Ticket ammount in USD $0.00

*High Ticket Ammount:

$	High Ticket Ammount in USD $0.00

*Monthly Volume:

$	Monthly Volume Total in USD$ 0.00

*Membership:

YES

NO

Is this business membership based ?

*Bankruptcy::

YES

NO

Has the Business or Owner ever filed for Bankruptcy ?

*Terminated ?:

YES

NO

Has the Applicant or Business ever been terminated?

*Processing History:

YES

NO

Do you have previous or current processing history for this business ?

*Payment Options:

Specify all other options of payment accepted other than credit cards.

*Customer Origin:

List major countries that your customers come from.

*Reason:

What is the reason you are applying for this merchant account ?


	Owner / Manager Information

*First Name:

First Name

*Last Name:

Last Name

*Phone:

- - x

Owner / Manager Telephone Number

Fax Number:

- -	Fax Number to send contract or documents for signature.

*Cellular / Mobile:

- -	Cell phone or mobile phone number.

International Phone:

International phone number can be entered here.

*Title:

*DOB (YYYY-MM-DD):

Date of birth format: DOB (YYYY-MM-DD)

*Email:

Enter multiple email addresses on separate lines.

*Image Verification:

Enter the code above.

Security Code