Apply to become a Concierge merchant

Contact

We'll send your application status here. You'll set your portal password after approval.

Work email

Business phone

Business

Legal business name

Exactly as it appears on IRS documents.

Storefront or DBA name (optional)

Business type

State of formation

Tax ID type

Tax ID 🔒 Encrypted

Year founded

Website (optional)

What does your business do?

Services

Choose every service you want to offer. You can add more later.

Medical courierFlagshipPrescriptions, specimens, supplies. HIPAA, chain of custody, temperature control.

Food deliveryRestaurants, cafes, caterers, ghost kitchens.

Retail deliveryGrocery, convenience, boutiques, hardware.

Customer courierDocuments and parcels, point to point.

Business category

Average order value, USD (optional)

Expected orders per week (optional)

Number of locations

Business address

Drivers pick up at this address

Hours of operation

When can drivers pick up orders? Times are local to your business.

Average prep or handoff time, minutes

Owner or authorized representative

Federal rules require us to verify the person who controls the business. Full identity verification runs through our payments partner after review.

Legal first name

Legal last name

Title

Ownership %

Email

Mobile phone

Date of birth 🔒 Encrypted

Last 4 of SSN 🔒 Encrypted

Home address 🔒 Encrypted

Anyone else who owns 25% or more of the business (up to 3)

Payout bank account 🔒 Encrypted

Payouts go to a US business bank account. Numbers are encrypted the moment they reach our servers, and only the last 4 digits are ever shown.

Account holder name

Account type

Routing number

Account number

Confirm account number

Documents

PDF, JPEG, PNG or HEIC, up to 10 MB each. Files are stored privately and only our verification team can view them.

Review

Agreements I agree to the Concierge Merchant Terms.

I have read the Privacy Notice and consent to identity and business verification.

I am authorized to act for this business, and the information above is accurate.

Grow with Concierge delivery