Merchant Services Pre-Application

Interested in getting a quote on ChargeLogic Merchant Services? Provide us with the information requested in the form below and we’ll connect you with a specialist and an analysis of how much you can save by working with ChargeLogic.

ChargeLogic Merchant Services Pre-Application

Tell Us About Your Business

Which Microsoft Dynamics product are you using or considering using? (required)

Business Name (Doing Business As)(required)

Legal or Corporate Name (if different)

Country (required)

Business Website Address(required)

Business Category (if known)

Describe your business(required)

What do you do? Who are your customers? What is your general industry?

Are You Working With a ChargeLogic Partner?

Please tell us what ChargeLogic Partner you are working with, see a full list of partners here: www.chargelogic.com/partners.

What is your estimated go live date for ChargeLogic Payments?

Business Contact Information

Please provide your business contact. This address will receive information regarding your merchant services application as well as monthly invoices and non-technical communications about your ChargeLogic account.

Name(required)

Email Address(required)

Phone Number(required)

Sales Volume Assessment

Your Total Annual Cash & Credit Sales (For All Locations)

Highest Ticket Amount

Estimated Average Ticket/Sales Amount

Statement Analysis

Please provide us with the last three statements from your current merchant service provider so we can verify the transaction volume and provide you with a rate analysis.

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