Redwood Merchant Services

1. Legal Business Name*

2. Doing Business As

3. Time in Business*

4. Business Type*

Retail

Restaurant

eCommerce

MOTO (Mail Order / Telephone Order

Business to Business

Other:

5. Average Monthly Processing Volume*

Less than $2,000

$2,000

$5,000

$10,000

$20,000

$35,000

$50,000

$100,000

$500,000

More Than $500,000

6. Average Sale Amount*

Less Than $10

$10

$25

$50

$100

$250

$500

$1000

$3000

More Than $3000

7. Are you currently processing credit cards?*

Yes

No

8. Type of Products / Services Sold*

9. Contact Information

*Number of Locations:

*Contact Name:

*Work Phone:

Cell Phone:

*Email:

*City:

*State:

10. Please list your specific business requirements*

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