Elavon Application
In order for us to enable the Elavon payment facility as part of your online appointment booking service, you will need to sign up to our Elavon services.

Please fill out all of the details requested in the form below, in order for us to process your application.

If you are unsure of any of the information that is being requested you may need to contact your merchant acquirer.
Sign in to Google to save your progress. Learn more
Email *
Your PPS Registration Number *
Your merchant acquirer *
**Note**

If your merchant acquirer is not in the list above, please email sales@rushcliff.com with more details including the name of your merchant acquirer and your eCommerce merchant ID number.
If your merchant acquirer is Worldpay, please also provide your Company ID
Your eCommerce merchant ID *
Merchant account registered name *
Please tell us the name under which your merchant account is registered.
Your website *
Please enter the web address where you currently host the online appointment booking service that you intend to use with Elavon.
Thanks for your time!
Now we have all of your details we can process your application. Once the application has been submitted to Elavon, it can take up to 4 working days before your account is activated.

If for any reason we need to contact you for further information to support your application we will do so via email using the registered email address on your PPS account.

Once we receive notification from Elavon that your application is complete, we will activate the payment facility for your online booking service immediately. You will receive an email to confirm when this has been done which will also contain any information you might need to start using your new payment facility.

Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rushcliff. Report Abuse
Google Forms