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Referral Application
= Required Field
Your customers deserve the prompt attention and outstanding payment processing service that Bluestone Payments will provide. Once you complete and submit this electronic referral form, a Bluestone Payments account executive will contact your client within 24 hours.
Bank Information
Bank Name
Contact Name
Branch Manager
Telephone
Branch/Address
Email
Merchant Information
Company Name
Telephone
First Name
Last Name
Address
City
State
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Alabama
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Email
Mobile
Average Ticket
Monthly VISA/MC volume
Comments
Other Information
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Retail
Restaurant
Services
Lodging
MOTO
Internet
Other
Industry
Existing bank customer?
Accepts VISA / MC
Accepts AMEX
Accepts Discover
Accepts Gift Cards
Accepts Check Services
