Referral Partner Information

Full Name *

Email *

Phone *

Primary Contact Information

Street Address *

City

State

Country

Postal code

Website *

Eligibity Confirmation

Are you a U.S.-based business? *

Yes

Have you been convicted of a felony? *

Yes

Additional Information

How did you hear about us?

Preferred Contact Method *

Phone

Text Message

Upload Drivers License *

Voided Check

Disclaimer: By submitting this form, you acknowledge that The Gatlic Group requires all agency owners to be based in the United States and will conduct a background check as part of the onboarding process. A clear felony history is a requirement for approval to ensure safe and compliant credit card processing. This measure helps protect both your agency and your clients, aligning with industry standards for secure payment processing. *

I agree to the terms agreement.