Maxx Merchants > Application

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First Name:	What is your expected monthly credit card volume?
Last Name:	< $25,000	$25,001 - $100,000
Title:	$100,001 - $500,000	> $500,000
Business Name:
Business Phone #:	Do you need information on credit card terminals or processing software? Terminals Software We don't need any information.
Email:

Do you currently accept credit cards? Yes No

How do you receive the majority of your credit card orders?	When would you like this credit card processing service to begin?
In person By phone Mail / Internet
	ASAP Within 1 month 1-3 months 3+ months
What is your average credit card receipt?
$1 - $100 $100 - $500 $500 - $1,000 > $1,000	What is most important to you? (Please comment)

American Express and Discover require separate approval.