5 min to fill up

30-day  Trial Application

1Fill out application in 5 minutes
2Receive your formal package by mail or fax
3Send back your package with supporting documents
430-day no obligation trial*
  • *If you are not 100% satisfied during the trial period, you just walk away from our service without any penalty!
  • If you will keep our service after trial, you have the choice to purchase or lease the terminal with a 4-year term or 5-year term with $150 rebate!

Prom Code:

Business Information
Legal Name:
DBA Name*:
Address:
City :
Province:
Postal Code:
Contact Name:
Email*:
Phone:
Fax(Optional):
GST(Optional):
Year Started:
Business Type:
Current Provider(Optional):
Owner/Manager/Controller Information
Date of Birth(Optional):
SIN(Optional):
Owner's Name:
Home address(Optional):
City(Optional):
Province(Optional):
Postal Code(Optional):
Home/Cell phone:
Equipment and Services
Terminal Type:
Services:
Payment:
Installation: YesNo
Other Comments:

*Any questions? Call 1(855)888 1234 or Live Chat Now!or go to our FAQ. or Contact us.

Top