Business Services
Merchant Services Interest Form

Thank you for your interest in Heritage Oaks Bank's Merchant Services. Please complete the form below, and one of our representatives will contact you.

Your Name:
 *
Business Name:
 *
Address:
 *
Address: (optional)
City:
 *
State:
 *
Zip:
 *
Phone:
 *
Fax:
Email:
 *
Business Type
 *
 Retail  Medical  Restaurant
 Lodging  Winery  Other
Preferred Contact Method
 *
 Phone  Fax  Email
Current POS User
 *
Yes No
Years in Business:
 *
* Required Information