Affiliate Request for Information

Complete the fields below and an
American Express representative will contact you.

By providing your e-mail address, we may use it to send you servicing messages and you agree to receive information about products, services and offers from American Express. If you provide us your personal e-mail address for purposes of this service, then we will use that email address as a business e-mail address for this service. For information about how we protect your privacy, please read our Privacy Statement. *Purchase and use of the American Express Payment Gateway are limited to merchants that accept the American Express Card. If you do not currently accept the American Express Card, you are not eligible to purchase or use the American Express Payment Gateway.