* Affiliate I
* Merchant: * Owner's
* Affiliate
Name: (Store Name) _..,..-
Name:
10: ----H------
_ -
* Owner's Business Phone:
--'_
Are they currently accepting credit cards?
Notes:
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type of business is it?
How many years in business?
~_~
Complete and fax to: 800-420-0395
_
Owner's Cell/Other Phone: _ ....•...
What is the nature of your relationship to the business owner?
* What
..•..
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_ _