Merchant Contact Form

Fill out this form to learn more about how your business can accept credit cards and various other payments.

*Required Fields

Contact Information

*Name of Business:

*Address

*City:

*State:

*Zip:

*Contact First Name:

*Contact Last Name:

*Contact Email Address:

*Contact Phone:

Secondary Phone:

*First Interstate Bank Branch:

*Annual Processing Volume

*Do you have an existing account with the bank?

Comments: Please list any information that may be relevant. ie: "best time to reach you", "type of business", "products interested in".