Accept DICKBUTT Merchant Interest Form
What language do you prefer?
English
Español
Português
Business Name
Category of Business
Services (Nail Salon, Barber, Massage, etc.)
Food and Goods (Liquor Store, Bakery, Coffee shop, etc.)
Independent Restaurant (non-franchise)
Franchise / Chain restaurant
Independent Retailer (Clothing, Jewelry, Fine goods, etc.)
Other
What does your business do or sell?
Provide more detail for customers to find you
What’s your store’s address?
What’s your full name?
What’s your email?
What’s your phone number?
What’s your mailing address?
Do you have a Coinbase Wallet? (You can sign to confirm ownership or create one below)
Yes
No
Were you referred by anyone? If so, enter their referral code.
SUBMIT
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