Save & Return

Use an account to return to saved work.

KHI Card Processing Merchant Enrollment Form

To ensure the quickest set up possible, fields marked with an * are required for completion. Merchant enrollment into the card programs will not progress until all required data has been provided. If you need to leave this page before completion, please use the Save Progress option at the bottom of each page so you do not lose your work.

Person Completing Form

Please enter information for the person completing this form.  You will be emailed upon submission with all information presented.
 +
By checking this box, I agree to conduct business electronically. *

Merchant Information


Physical Location Information