Registration Form

The role of the created user set to the default role. Only an administrator can register a user with the role assigned to this form.

Complete the form below to begin the registration process. A Veristone representative will review your application and a notice will be sent to you during normal business hours indicating your status. If approved, you will be able to login and gain access to all areas of Veristone’s website.

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    • This field is for validation purposes and should be left unchanged.