Regions

MERCHANT SERVICES PROCESSING REQUESTS

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Thank you for your interest in Regions Merchant Services. Please take a few moments to respond to the questions below so that we may better understand your business needs. Upon receipt of your information, a representative will contact you within 48 business hours.

THIS FORM PROVIDES US INFORMATION ONLY. IT IS NOT A CONTRACT FOR SERVICE.

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*Required Fields

First Name *

Last Name *

Name of Business *

State

Phone *

Email *

Confirm Email *

Best Time To Contact Me: *

Comments:

THIS FORM PROVIDES US INFORMATION ONLY. IT IS NOT A CONTRACT FOR SERVICE. THIS IS NOT A CREDIT CARD APPLICATION, IT IS ONLY FOR MERCHANT SERVICES.

By providing us with an email address you are expressly consenting to receiving email communications — including but not limited to Marketing material/Advertising, Promotions, Sales Campaigns, and Questioner/Research Surveys.

By providing us with a telephone number for a cellular phone or other wireless device, including a number that you later convert to a cellular number, you are expressly consenting to receiving communications — including but not limited to prerecorded or artificial voice message calls, text messages, and calls made by an automatic telephone dialing system—from us and our affiliates and agents at that number. This express consent applies to each such telephone number that you provide to us now or in the future and permits such calls for non-marketing purposes. Calls and messages may incur access fees from your cellular provider.

MERCHANT SERVICES PROCESSING REQUESTS

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