MERCHANT PRE-REGISTRATION

MERCHANT PRE-REGISTRATION


Instructions:
1. Fill up all required fields.
2. Submit to Bancnet.
3. Bancnet will process your application.

Name of Organization *	:
Business Address	:
Telephone Number	:
Fax Number	:
Principal contact in the organization	:
Estimated use of the Payment Gateway	:	(e.g. 6 months)
Nature of Business/Industry	:
Website (Domain Name)	:
Date of filing	:	(mm/dd/yyyy)
Date Plan to implement *	:	(mm/dd/yyyy)
Preferred Bancnet Member Bank - Existing Account?
Brief description of the Existing System
Questions:
1. How long have you been in the web business?		More than 20 years 16-20 years 11-15 years 5-10 years Less than 5 years
2. Do you host your own website?		Yes No
3. If no, who host your website?
4. As part of your plan do you want to accept Debit card and Credit Card as Payment?		Credit Card
		Debit Card
5. Others:

Harware/Software Checklist:
Description	Existing (Yes or No)
Webserver
- Pentium III or Higher	Yes No
- 128MB RAM or Higher	Yes No
- 4GB of free hard disk space or Higher	Yes No

Merchant Server Program (store front)	Yes No

Servlet Runner	Yes No

JDK 1.3	Yes No

Java Program to call Payment Module API (To be developed by the merchant)	Yes No

Secure Socket Layer (SSL) 3.0/Verisign (optional)	Yes No