Make a Referral Today!
If your financial institution participates in the PAI-BSG Referral program and you would like to refer a merchant for one of our Payment solutions, please fill out the form below.

Merchant Services Referral Form

Now earn $50 for every activated referral on the following 4 products:
(Please check the items that apply)
Merchant Bankcard Services (Visa-MasterCard-Discover-Amex)
Merchant Remote Deposit (Check 21)
Merchant ATM Purchase, Placement, or Reprogramming
Merchant Cash Advance (AMI)

And earn $25 for every activated referral on the following 2 products:
(Please check the items that apply)
Merchant Check Guarantee / ACH Express Program
Merchant Gift or Loyalty Card Program

Please complete all fields:

Financial Institution
Branch
Your Fax #
Your Email Address
Branch Contact Name
Phone:
Address to send your Gift Card:
Street
City
State
Zip Code
   
Business DBA Name:
 
Business Address:
Street
City
State
Zip Code
   
Business Phone:
Contact Person/ Title:
Type of Business:
Currently Accepts Credit Cards?
No
Your Account Executive is
Comments:
 


 
 
blank
Payment Alliance International is a registered ISO/MSP with HSBC Bank, USA, National Association, Buffalo, NY
Payment Alliance International is a registered ISO/MSP with First National Bank of Omaha