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The Yemeni American Group

The Yemeni American Group, staying true to our mission, where we promised creative ways, new products and more opportunities.
We are thrilled to bring you this opportunity to serve with dignity and gain with respect. Let’s get started!

انطلاقا من رسالتنا التي وعدتكم بسلع جديدة، طُرق مُبتكرة و فرص كثيره ، اليكم
هذه الفرصة للبيع بكرامة والربح باحترام .
فهيا بنا نبدا

Please complete the following application that will be used to generate your contract.
If you need help completing this form, please contact our Sales and Support Team at 877-535-4707 EST for assistance.

من فضلك قم بتعبئة الاستمارة المُرفقه لكي نبدا عملية تسجيل متجرك، واذا اردت مساعدة في التعبئة، نرجو الاتصال بالرقم التالي ؛

877-535-4707 EST

BUSINESS INFORMATION
All fields with an * asterisk are required and must be completed to submit the application. 

Name company is registered with the state

Business Name on the building

ex: 111-111-1111

ex: 111-111-1111

Mobile Phone number is required to receive a one-time password once the Terminal or Web Access is received. 

ex: 111-111-1111

This is used to configure terminal for transaction purposes.
TERMINAL DEVICE OPTIONS (SELECT ONE) 


BUSINESS ADDRESS INFORMATION

ex: 123 SW Main Street

ex: Suite, Building




BUSINESS BILLING INFORMATION

ex: 123 SW Main Street

ex: Suite, Building




ex: 111-11-1111
PRINCIPAL INFORMATION
Note: All Principal information is required and should include the business owner's personal information only




ex: 111-111-1111



ex: 123 SW Main Street

ex: Suite; Building



COMPANY INFORMATION



STATE ID/ TAX BUSINESS REGISTRATION INFORMATION




If applicable

If applicable

PROGRAM INTEREST 

ADDITIONAL INFORMATION






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