Centech

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Are you ready to start doing business?

Fill out the application form below to get started. You will be contacted by one of our professionals by the next business day.

Business Hours:
Monday - Thursday
8 a.m. to 5 p.m.

Merchant Legal Name:
DBA Name:
Years in Business:	Annual Visa/MC Sales:	Average Ticket:
Legal Address:
DBA Address:
DBA Phone:
Owner Name:
Date of Birth:
Business Industry:
Storefront: Yes No	Number of Locations:	Approx. SF:
Web Sales:	Yes No
Core Product or Service:
Web Address:
Contact Name:
Contact Phone:
Contact E-mail:
Describe any specifics about what you would like from Centech:
Please list any problems you have had with current merchant service providers: