MONERIS eSelectPlus Pre-Qualification Form

To get started setting up an eSelectPlus account with MONERIS, just complete this form. Click on Submit when ready to send. The form will be immediately forwarded to a MONERIS Merchant Services' account specialist, who will contact you within 3 business days.

If you have any problems with MONERIS Merchant Services not responding to you in a timely fashion, please call one of our MONERIS Merchant Services representatives,
Miriam Lenarduzzi (1-514-624-2495), or France Blanchard (1-866-888-6876), for prompt satisfaction.
Although you can mention "i-table", be sure to also mention that the type of account needed is an eSelectPlus type account.

Note: Merchant service organizations are extremely large. This form forwards your contact info immediately to the correct people within this organization. There is no obligation for doing so. Not filling out this form and phoning the merchant directly may actually delay things.

Required fields are in red.

Is your bank and business in Canada?

Please note: Currently, MONERIS Merchant Services requires that the bank and business be operating in the CANADA. USA customers please select one of the following providers instead 1st National or NOVA. We apologize to our other foreign customers, but please be aware that we are looking forward to offering more global solutions later.

Your name and title:

Your email address:

Telephone:

Fax number:

Business name:
(Enter 'N/A' if not applicable)

Mailing address:

Merchant acct. application:

What credit cards would you like to accept?

Please check all that apply.
Note that the credit cards below are the only ones that work with our kiosk software and Wi-Fi firmware at this time.
Visa/MasterCard |American Express | Discover | Diners

Projected annual Visa/MasterCard sales volume (if available):

Projected average Visa/MasterCard sale (if available):

Thank you for your interest in acquiring an eSelectPlus merchant account from
MONERIS Merchant Services (Canadian transactions only).

MONERIS' eSelectPlus interface is compatible with the i-table!® eCommerce Gateway server.

Is your bank and business in Canada?

Your name and title:

Your email address:

Telephone:

Fax number:

Mailing address:

Merchant acct. application:

What credit cards would you like to accept?

Please check all that apply.
Note that the credit cards below are the only ones that work with our kiosk software and Wi-Fi firmware at this time.
Visa/MasterCard |American Express | Discover | Diners

Projected annual Visa/MasterCard sales volume (if available):

Projected average Visa/MasterCard sale (if available):

Any comments?

Thank you for your interest in acquiring an eSelectPlus merchant account from MONERIS Merchant Services (Canadian transactions only).