Partner with Confidence. Refer with ease.

When you refer to Basys, your merchants gain access to seamless and tailored payment solutions that fit their unique business needs.

Simply submit this form, and we’ll take it from there – a Basys representative will connect with your referral soon to start delivering the support they deserve.

We value your partnership and are excited to help your merchants thrive. If you have any other questions, give us a call at 800.386.0711.

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Name (DBA)*

Address*

City/Town*

State*

Zip Code*

Email*

Services/Products

Contact Name*

Contact Phone Number*

Best Time to Contact Merchant*

Approx Monthly Credit Card Sales*

Does the client currently accept credit cards?*

Yes

How does the merchant process?

Is the merchant a client of the bank?

Yes

Urgency of Request

Normal

Urgent

Upload Merchant Statement

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Max. file size: 100 MB.

optional

Name*

Email Address*

Phone Number*

Branch Name*

Bank Officer Code*

Cost Center

Please recap your conversation with this prospect

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Thank you for partnering with Basys!

Partner with Confidence. Refer with ease.