Inquiring Merchant Questionnaire
Please fill in all fields marked with a *
Company
*
Contact Name
*
Position
*
Phone Number
*
Alternate Number
*
Fax Number
*
Email
Street Address
*
City
*
State
*
Zip Code
*
How did you hear about us
*
Type of Store
Convenience or Misc Retail
Wireless
Cash Advance or Check Casher
Pawn
Other
*
Number of Locations
*
Do you sell prepaid home phone service
Yes
No
*
What companies do you currently offer
How many customer payments per month
Any concerns with the company you offer now
Do you sell prepaid wireless phones
Yes
No
*
Do you want to offer PINs for any prepaid wireless company
Yes
No
*
Does your store have a computer with internet
Yes
No
*
Do you want more information of taking payments for all bills
Yes
No
*
Do you want to offer prepaid debit cards
Yes
No
*
What percent of your customers are Spanish
None
25 percent
50 percent
75 percent
100 percent
*
Do you have need for Promotional items in Spanish
Yes
No
*
Do you know stores that would like to offer prepaid products
Yes
No
*
Please type any other questions you may have here
How do you want information
Email
Fax
Telephone
*