Submit an application

Complete the form below and the merchant will be contacted directly to complete the application.

Agent Name

Director Full Name

Date of Birth

Phone

Email Address

Director Home Address

Director Home Address Postcode

Moved into Home address

Company website

Any additional Info or different terminals (2nd directors/partners)

Attach proof of business

Upload File

Attach proof of ID

Upload File

Company Name/Legal Entity

Trading Name

Company Trading Address

Company Trading Address Postcode

Business bank account name (on business bank statement)

Business Bank Sortcode

Business Bank Account Number

Debit Card rate

Credit Card rate

Auth Fee

Number of Clover Flex Terminals

Attach proof of bank

Upload File

Attach proof of home address

Upload File

Thanks for submitting