Merchant Pre-Approval Application

Please complete the form to below to submit your information for pre-approval for a merchant account with one of the MCPS merchant providers. Your information is kept safe and will not be redistributed to any other party other than merchant provider partners for the sole purpose to obtain a merchant account.

Step One - Merchant Information


DBA (Doing Business As) Name
Legal Name of Business
Business Phone
Business Fax
Business Address
City
State
Zip Code
Do you wish to apply for Discover? YesNo
Do you wish to apply for American Express?YesNo
Main Phone Number
Merchant Website URL
Authorized Company Contact
First Name
Last Name
Title or Relationship
Contact E-mail

Step Two - Owner Information


Principal's Information
First Name
Last Name
Date of Birth
Home Phone
Ownership %
Owner's Home Address
City
State
Zip Code

Step Three - Business Information


Business Type (e.g., I sell pet supplies)
Business Ownership Type
Home Business? YesNo
Average Monthly MasterCard/Visa Volume
Average Sale/Ticket Amount