Sales Partner Enrollment Form

First Name

Middle Name

Last Name

Email Address

Daytime Telephone

Mobile Telephone

Street Address

City/Town

State

Zip Code

Business Name (d.b.a.)

Federal EIN or Tax ID#

Your Preferred Payment Method

Name of Bank

Account Number# (not to exceed 17 digits)

Routing & Transit Number# (requires 9 digits)

Note: Bonuses are paid daily, weekly, and on the 15th of each month. *Residual commission earnings on merchant credit card processing volume is paid on the 15th of each month.