Personal
Information
Order
Type
Payment
Gateway
Both
Total Fees: US$
Do
you have US SSN?
No: $150
Yes: $0
Your
Name
*
E-Mail
*
Date
of Birth
*
Social
Security Number (SSN)
Home
Address
*
City,
State / Province, Zip / Postal Code
*
Country
*
Phone
* With
Area Codes
Fax
With
Area Codes
Corporate
Information
Business
Structure
US
Business Name
* (Not
Incorporated in USA ? Do
it Now )
Street
Address
*
City,
State / Province, Zip / Postal Code
*
Country
*
Phone
* With
Area Codes
Fax
With
Area Codes
Business
E-Mail
*
Business
Website
*
Existing
Merchant ID (if any)
Federal
EIN #
* Apply Now )
Date
this business was established
*
US
Business Bank Account Number
* (Don't
have US Bank Account ? Apply
Now )
ABA/Transit
Routing#
*
Name
of Bank
*
Branch Address
*
Merchant
Information
Type
of Business
*
Average
Item Price
*
Monthly
Volume: $
*
Card
Acceptance Type
*
Services
/Products
*
User
Information
Preferred
UserID
*
Password
*
Re-Type
Your Password
*
Payment
Information
We
accept payments by Wire Transfer ONLY . Shortly, in
reply to your order, you will receive Wire Transfer instructions
and payment details.
Amount: US$
+ $35 (Wire Transfer Fee)
Where
did you hear about Apelles.com ?
Please Choose One
Web Hosting Talk
Forum
Search Engine
FFA Link Pages
Banner Ad.
Promotional Email
Recommended by a
friend
Referred by
existing client
Comments
or Account Setup Instruction
Your
order will not be processed until we receive: copies of your
Passport, National ID card / Driving License, Utility Bill
eg. Telephone/Electricity Bill and the Payment Wire. Scanned
Images accepted.
