GA-ASI ActivePay® Enrollment Form

How to enroll in the ASI ActivePay® program:

  • Complete all fields listed on Supplier Enrollment Form below.
  • List each remittance E-MAIL address. (Usually accounts receivable or person dedicated to processing credit card transactions. GA-ASI recommends a dedicated group E-mail address).
  • Submit form by clicking the Submit button below.
  • Once completed enrollment form is received, a confirmation letter will be e-mailed to the designated contact person.


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