Merchant Application

Username*

Username*

Email*

Email*

First Name

First Name

Last Name

Last Name

Store Name*

Store Name*

https://allegheniesmarketplace.com/store/[your_store]

Address 1*

Address 1*

Address 2

Address 2

Country*

Country*-Select a location-United States (US)

City/Town

City/Town

State/County

State/County

Postcode/Zip*

Postcode/Zip*

Store Phone*

Store Phone*

Tell Us About Your Business*

Tell Us About Your Business*

Are You a Registered Business?*

Are You a Registered Business?*Yes as an LLC Yes as a Sole Proprietorship Yes as an S Corp Yes as a C Corp Not Yet

Which county are you/your business located in?*

Which county are you/your business located in?*Bedford Blair Cambria Fulton Huntingdon Somerset

Password*

Password*

Confirm Password*

Confirm Password*

* Agree  Terms & Conditions