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Merchant Services Referral Form
Earn a $25 Visa/MC gift card for each New Activated Account you refer!
Please complete online form below
Your Merchants' Choice representative will contact your customer within 24-48 hours of receiving this referral

Business Information:
Business Name:    
Contact Name:    
Business Address:    
Business Phone: Alternate Phone:
Best Time To Call:    
Referral Information:
Bank Employee Name:    
Phone Number: Email:
State:    
Bank Name:    
Branch Location: MCPS Bank ID Number:
Notes: (Please include any information that would assist us in closing the sale)

Taylor Kelly, President (800) 617-5315   tkelly@mcpspartners.com
Gary Boshell, Chief Operating Officer (800) 617-5315   gboshell@mcpspartners.com
Vice President of Sales and Marketing    
THANK YOU FOR YOUR BUSINESS

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