If youwould like to receive additional information about becoming aPlug'n Pay Reseller or Partner, please call 800.945.2538, or complete the fields below and click SUBMIT.

A Plug'n Pay representative will be in touch with you promptly.

Reseller/Partner Information Request
Company Name:
Contact/Title:
Address:
City, State, Zip:
Telephone:
Best Time To Call:
Fax:
E-mail:
Enter your website URL:
 

Please provide us some information about your current marketing structure:
 

Do You Currently offer E-Commerce? Yes     No
If so, how?
What Best Describes Your Market Position:
Est. Number of New Monthly
E-Commerce Accounts:
Est. Monthly Credit Card Volumes:
Number of Salespeople:
URL of Intended Plug'n Pay Link on Your Site:
Notes or Comments: