Fax Referral List

We welcome your referrals!  To earn Affiliate Rewards, check out our Affiliate Program.  Print, complete and fax your referral list TOLL FREE to: 1-800-398-1709.

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Your Name: ______________________________
Your Phone: ______________________________
Your Email: ______________________________
Contact Name: Business Name: Phone Number: Email:

Merchant Services
Office: 1-800-253-9679
Fax: 1-800-398-1709

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