Merchant Inquiry

If you are looking for a merchant account and/or payment gateway to process transactions, please call us at 866-437-0476 (Monday - Friday, 6 AM - 5 PM Pacific time) or fill out the form below.

* Required field

First Name:

Last Name:

organization Name:

Job Title:

Address:

City:

State:

Email Address:

Phone Number:

--*

I am interested in (check all that apply):

	Payment Gateway Account
	Product Information
	Pricing Information
	Finding a Reseller
	Other

Do you have a merchant bank account?

	Yes
	No
	Don't Know

Do you have an Authorize.Net Payment Gateway account?

	Yes
	No
	Don't Know

Do you have a relationship with an Authorize.Net reseller?

	Yes
	No
	Don't Know

I am currently a (check all that apply):

	Web Merchant
	Retail Merchant
	Mail Order/Telephone Order Merchant
	Mobile Merchant

How did you hear about Authorize.Net?

Comments:

Copyright 2005, 2007. Authorize.Net is a registered trademark of Lightbridge, Inc.	Terms of Use
All other marks are the property of their respective owners. All rights reserved.	Site Map \| Privacy