Pick a Plan

Application

A simple survey to determine eligibility for our products and services.

- Step 1 of 11

Name *

First

Middle

Last

Email *

1-How many staff are regularly part of your business (include temporary and part-time staff)? *

	1 to 30	31 to 50	51 to 250	251 to 500	Over 501
Select option	Select option 1 to 30	Select option 31 to 50	Select option 51 to 250	Select option 251 to 500	Select option Over 501

2-What was last year's total business revenue? *

Less than $3 million
$3 million to $8.9 million
$9 million to $39.9 million
$40 million to $99.9 million
More than $100 million

3-How many workplace sites does your business operate? (Only count business offices, not employees working from home.) *

2 or fewer
3 to 7
8 to 14
15 to 25
Over 25

4-What is the average number of customer or partner financial transactions, including credit cards, accepted or sent in a day? *

None
Up to 100
Between 101 and 500
Between 501 and 4999
More than 5000

5-In how many states and territories does your business have customers or employees? *

Only 1
2 to 10
11 to 35
36 or more

6-Would your business answer "Yes" to any of the following questions: Are you doing business with customers or suppliers or partners outside of the US or Mexico? Do you have staff outside of the US or Mexico? Do you have business in the European Union? *

7-Has your business ever entered into a Business Associate Agreement with a Covered Entity under HIPAA/HITECH, or is your business a Covered Entity under HIPAA/HITECH? *

8-Is your business considered to be any of the following? - Bank or Credit Union - Financial Advisor - Wealth Management Firm - Mutual Fund or Trust - Insurance Company - Accounting Firm - Commercial Lender - Investor - Pawn Broker - Auto Dealership *

9-Does your business engage in any of the following? Sell products or services online (i.e. eCommerce) - Accept payments by credit card, bank transfer, or third-party payment vendor. *

10-Does your company offer any of the following services to customers? Managed IT services - Website Hosting - Software as a Service (SaaS) - Network/IT security services.

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