Merchant Quick Form - Cascadia Pay

Your Name *

Email Address *

Telephone:

I Prefer To Be Contacted By:

Your Website:

Fully Describe The Product Or Service Being Offered: *

Name Of Business:

Country Of Business Incorporation:

How Old Is Your Business:

Monthly Processing Volume (If New Business, Provide An Estimate Of Anticipate Volume):

Average Order Amount ($):

Maximum Order Amount ($):

Average Monthly Chargeback Ratio:

Do You Process Any Recurring Payments?

Are You Already Processing Elsewhere?

If Already Processing, What Is The Discount Rate (%) You Are Currently Paying?

The Name Of My Current Credit Card Processing Provider Is:

If You Are Not A New Business, Explain Clearly Why You Are Interested In Moving To A New Merchant Account: