Contact Info:
Store Name:
If you would like any part or all of
your address and contact phone number to appear in your
shopping cart, please complete this next area:
Address:
City:
State:
Please Select
-----------------------
AL - Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
DC - District Of Columbia
FL - Florida
GA - Georgia
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
ZIP:
Phone:
Fax
E-mail address:
Shipping:
USPS
UPS
FEDEX
Flat Rate
Other
(http://www.uspswebtools.com/registration/)
If other or flat rate,
please explain:
Is
there a handling fee? If so please specify:
Payment:
How will
you accept payment?
Please select all that apply:
Visa
Mastercard
Amex
Discover
Paypal
Check
Money Order
COD
Do
you already have a Merchant Account?
Yes
No
If Yes
with whom?
Please note that you can have Miva process
payment through "Credit Card Payment with
Simple Validation " which means that Miva
will collect all information and then you can manually
process the credit card with a credit card machine at
a later time (like the next day). At that time, whichever
Merchant account you use will validate the credit card
and transfer the money into your business checking account.
You may also select a "payment gateway" .
Miva will collect all information and interface directly
with a payment gateway that will verify the credit
card on the spot and accept or decline it. It will
also automatically transfer the money into your business
checking account right then and there. This is an example
of the charges for Miva Payment (please check with
vendor as prices might change):
One-time
set-up:
$50.00
Discount rate:
2.39%
Transaction fee:
$0.25
Monthly customer
service fee:
$15.00
Monthly minimum:
$25.00
Which method would you
like to use ?
Credit Card Payment with Simple Validation
Payment Gateway
Your Merchant account will want
to insure that you have a privacy policy posted somewhere
on your website. A privacy policy tells the customer what
you will do with the information you have collected.
Do
you have a privacy policy or do you want us to supply
one for you ?
Yes, I have one
No, please supply one
If you
have one please place it here:
Order Fulfilment:
Please
write the response letter that you would like your customer
receive after he has placed an order. Generally, it would
go something like this:
Thank you for your order. We appreciate
your business. Your product will be shipped by UPS
and it will take 5 to 7 business days. If you have
any questions, please contact us at info@yourstore.com
or call us at 1-800-777-7777.
Product Information:
How many
products will be in your cart?
Will
your products have any special attributes (i.e. S,M,L)?
Yes
No
If yes
please explain:
Enter
products and price:
Enter
product categories separated by commas. (i.e. Tapes,
CDs, Books, Shirts, Shoes etc..)
Do you charge state sales tax? if
so how much?
Additional Comments:
Please
enter any additional comments in the text box below.