Please fill in this form. We will then contact you as soon as possible. NB: A copy of your ID, bank statement and financial statements of the past two year is necessary for our partner assignment policy. Partner information Desired Partnership * - Select -Payment solutions (Acquiring and/or Terminals)Fraud solutionsOther solutions Expected number of terminals sold annually Expected number of acquiring contracts sold annually Which segment/countries are your merchants operating? Please describe your business in short * Company information Company name * Website * VAT/KBO number (or similar) * Contact person Phone number Contact person * Business e-mail * Number of (direct) sales people working for your company * Leave this field blank What code is in the image? * Enter the characters shown in the image.