Merchant Application Form

Business Information

How long have you been banking with us?

Estimated Monthly Deposit Volume
Types of Services
Type of Terminal
Card Service Accepted/Recommendation
Important Information

I/We understand that if any of the above information is subsequently changed or modified that I/We must notify the BANK within five (5) business days of said change.

By submitting this form I agree that the BANK may use that information to establish and maintain my/our relationship with the BANK and to offer any services as permitted by law.

When you have filled in all the appropriate fields of the form, Click on the SUBMIT button, You will be contacted shortly by one of our officers. Thank You!

For more informtation please contact us at 715-5520 or