GoodForUs Application

Please fill out the merchant application and ensure that all required fields are complete. Thank you!

Personal Information

Personal Information

Name *

Title

Phone *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Affirmation *

The above information is true and accurate.

Authorized Representative

Authorized Representative

Authorized Representative *I AM THE AUTHORIZED REPRESENTATIVEI AM NOT THE AUTHORIZED REPRESENTATIVE

Upload Photo Identfication *

No file chosen

Affirmation *

The above information is true and accurate.

MESSAGEOnly authorized representatives are permitted to submit this form. If you believe you should have access, please contact your administrator for assistance. Thank you!

Business Information

Business Information

Church/Organization Name *

Street Address *

City

State/Province

ZIP / Postal Code

Country

Phone *

Business Email Address *

Affirmation *

The above information is true and accurate.

Payment Types

Payment Types

select payment types *TithesDonationsOfferingFundraisersOTHER

Affirmation *

The above information is true and accurate.

Banking Information

Bank Name

Account Number

Banking Information

Routing Number

Affirmation *

The above information is true and accurate.

Attestation

Attestation

CheckboxI hereby attest that the information provided in this application is accurate to the best of my knowledge.

Please do not fill in this field.