Online Credit Card Services, Inc.

Application Form

By completing this form and transmitting it to us, you are providing us with the information we need to provide you with a complete rate and service quotation for credit card processing and other related services such as check services, gift and loyalty card services and other services that you may require. PLEASE Complete all sections of this form so that we may serve you better! Macintosh users who experience problems with this form should print it and fax it to 508-347-5962. If you experience any other difficulties completing and transmitting the form, please call 1-800-538-1556.

We cannot respond to application requests without a valid business phone number or a valid phone number for the business owner. If a business phone has not been installed yet a personal cell phone is also acceptable if that is the best way to reach you. At least one valid phone number must be entered in order for you to submit this application request.

*Required
*Name:		Company:
Street Address:
City:			State:	Zip Code:
Mailing Address (if different):
City:			State:	Zip Code:
*Home Phone: (include Area code)	*Business Phone: (include Area code)
Cell Phone: (include Area code)	Fax: (include Area Code)
Website Address:	Email Address:

*Quick Survey, please check the appropriate boxes that apply to you and answer the following questions:*
Years in Business:
Type of Business:
Service: , if Other please Describe...
Are You Currently Processing?
Vendor Name:
Average Per Sale Amount?	$
Is amount: Actual or Estimated
Monthly Mastercard/Visa Volume	$
Is amount: Actual or Estimated
If you are currently processing with another vendor and you are dissatisfied, please tell us about your experience in the questions and comments box below. If there are any other questions or comments that you want to communicate to us please include them below and then click on the “Submit Application” button.

Servicing U.S. Businesses Coast to Coast Including Hawaii

P.O. Box 795, 54 Main Street, Sturbridge, MA 01566
Toll Free 1-800-538-1556 or Email info@onlinecreditcard.com
A registered ISO/MSP since 1986
PRIVACY POLICY

On-Line Credit Card Services, Inc., is an Independent Sales Organization registered with Visa and Mastercard by Columbus Bank and Trust Company Columbus GA.