MarijPay Solution Application

Submit the below form and we will follow up with options and next steps.  Please note, not all companies will have available solution options.  In those cases, we provide operational feedback to help you with your planning. Note, your info is private.  We do not sell or provide your information to any third parties until you have reviewed options and provided us permission to pursue solutions you have selected.

First Name Required field!
Last Name Required field!
Company Website Required field!
Email Required field!
Please select the state your operating entity is in. Required field!
Which option best describes your business?* Required field!
Are you currently licensed to operate your business?* Required field!
Are you open and doing business today?* Required field!
If you're business is open, please select monthly sales volume.* Required field!
Which category does your company fall into?* Required field!
Which POS do you use today?* Required field!
Do you offer delivery services?* Required field!
Do you accept payments today?* Required field!
In a few sentences, describe what solution options you would like to learn more about.* Required field!
Please upload last 3 current months payment vendor statements if requesting payment solution options. Required field!
When are you hoping to implement a new vendor or solution?* Required field!
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