Fields with stars are required.
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Briefly describe how this MID will be used to accept payments. Include any third party service providers/gateways that might be involved (e.g., hosted payment page, virtual terminal, P2PE device, mail order/phone order, use of third party service provider, etc.).
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This will be the name that your customers see on their credit card statement. We recommend that you make it something they will easily be able to identify when they review their card statement.
(22 characters max including spaces)
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Contact person
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Finance contact
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Technical contact
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PCI compliance contact
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(e.g., Student and Campus Life, CALS, College of Veterinary Medicine)
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(e.g., Cornell Dining, School of Integrative Plant Science, Cornell Athletics)
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$
.00
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Will you be collecting sales tax? *
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Do you wish to accept e-Check? *
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*e-Check will permit you to process ACH transactions on the hosted payment page or in the virtual terminal; this will equire a separate MID with fees of $19.99 per month plus $0.20 per transaction.
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Could any of the funds collected be classified as gifts? *
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Will this MID need to be linked to an existing CardConnect MID
for PCI compliance/reporting purposes? *
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Account and Object Code fields are required.
