To complete the merchant application please provide all applicable
information in the areas provided.   For your convenience you can fill out
the application on line, print, sign and fax to:
631-396-3969.  For site
survey, complete form and fax along with your application.

If you have any questions, or need assistance during the application
process, please call one of representatives at:  
631-396-3965, or toll free
at:
800-591-6553.
Alliance Merchant Services, Inc. is a registered ISO/MSP of BancorpSouth Bank, Tupelo, MS.

American Express and Discover require separate approval.
Applications submitted via this site must be accompanied by a hard copy with an original signature.
Merchant applications
Please be advised that this is for preliminary review and a hard copy application and program
guide will follow.  
Click To Open
Merchant Application
Click To Open Leasing
Application