• No Requirment to accpeted card payments
• Requirment to accepted card payments

Fields marked with an asterisk (*) are required.

 

Confirm if the business has a requirement to accept credit or debit cards payment online, phone or in store *

Please Select Yes No

Discuss with customers if there is a need for this product before completing a referral to AIBMS

AIB Staff Information

Lead Source *

Select a Source AIB UK Branch ROI (customer present) Branch ROI (Customer not present) Capital Markets Business Banking Business Banking Branch Network (BBBN) Corporate Banking Customer Engagement Centre

Lead Source *

Select a Source AIB UK Branch ROI (Customer not present) Capital Markets Business Banking Business Banking Branch Network (BBBN) Corporate Banking Customer Engagement Centre

Hidden Lead Source

Referral Branch *

Select a Branch Customer Engagement Centre 930105 Business Banking Branch Network 000015 Capital Markets Business Banking 000017 Corporate Banking 930806 AIB UK 000014 1/4 Lower Baggot Street 931012 106 O'Connell Street 935247 66 South Mall 934178 Abbeyfeale 935018 Adare 935093 Ardkeen 934402 Arklow 933023 Artane 932078 Ashbourne 932396 Athenry 937010 Athlone 932264 Athy 933368 Balbriggan 932019 Ballina 937029 Ballinamore 937037 Ballinasloe 937045 Ballincollig 934011 Ballinrobe 937053 Ballybofey 937363 Ballyshannon 937185 Bandon 934046 Bantry 936014 Birr 932272 Bishopstown 934321 Blackpool 934054 Blackrock 933678 Blanchardstown 932515 Bray 933481 Buncrana 937290 Cabra 932280 Cahir 935042 Callan 933090 Capel Street 931101 Carrickmacross 932035 Carlow 933104 Carndonagh 937355 Cahersiveen 936030 Carrick On Shannon 937061 Carrick on Suir 935050 Carrigaline 934313 Cashel 935069 Castlebar 937088 Castleblayney 932426 Castleisland 936251 Castlerea 932558 Castletownbere 936278 Castletroy 930148 Cavan 932051 Celbridge 933503 Charleville 936189 Claremorris 937444 Clifden 937398 Clonakilty 936057 Clondalkin 933511 Clonmel 935379 Clonskeagh 931187 Cobh 934062 Cornelscourt 933392 Crumlin Road 931020 Dame Street 932086 Dingle 936286 Donegal Town 937304 Douglas Road 934348 Drogheda 932094 Drumcondra 932108 Dundalk 932450 Dundrum 933120 Dungarvan 934070 Dungloe 937339 Dun Laoghaire 933406 Dunmanway 936073 Edenderry 932469 Ennis 935387 Enniscorthy 933414 Ennistymon 935158 Fermoy 936081 Fethard 935395 Finglas 932132 Gorey 933643 Gort 937118 Grafton Street 931047 Greystones 933554 High Street,Kilkenny 933198 Kanturk 936316 Kells 932531 Kenmare 936324 Killaloe 935417 Killarney 936332 Killorglin 936340 Kilmallock 935212 Kilrush 935425 Kinsale 934089 Leixlip 933635 Letterkenny 937347 Lisduggan 934119 Lismore 934186 Listowel 935433 Longford 932140 Loughrea 937428 Lucan 933562 Lynch's Castle 937096 Macroom 936138 Mallow 936146 Manorhamilton 937134 Maynooth 933201 Midleton 934127 Millstreet 936154 Mitchelstown 936162 Monaghan 932477 Mullingar 932175 Naas 933236 Naas Road Business Bank 931004 Navan 932183 Nenagh 935220 Newbridge 933244 Newcastle West 935239 New Ross 933430 Portlaoise 933279 Raheny 932345 Ranelagh 931292 Rathdowney 933597 Rathfarnham 933295 Rathgar 931071 Rathkeale 935263 Roscommon 937142 Roscrea 935271 Salthill 937401 Sandymount 933600 Santry 932353 Shannon 935484 Skibbereen 936375 Sligo 937258 South Richmond St 931160 Stillorgan 933570 Swinford 937266 Swords and Malahide 932523 Tallaght 933317 The Quay 934275 Thurles 935301 Tipperary 935328 Tralee 936219 Tramore 934291 Tuam 937150 Tuam Road 937452 Tubbercurry 937274 Tullamore 932256 Tullow 933325 Western Road 934194 Westport 937169 Wexford 933341 Wicklow 933619 Youghal 934305

Referral Branch UK *

Select a Branch AIB UK 000014

Referral Branch ROI *

Select a Branch 1/4 Lower Baggot Street 931012 106 O'Connell Street 935247 66 South Mall 934178 Abbeyfeale 935018 Adare 935093 Ardkeen 934402 Arklow 933023 Artane 932078 Ashbourne 932396 Athenry 937010 Athlone 932264 Athy 933368 Balbriggan 932019 Ballina 937029 Ballinamore 937037 Ballinasloe 937045 Ballincollig 934011 Ballinrobe 937053 Ballybofey 937363 Ballyshannon 937185 Bandon 934046 Bantry 936014 Birr 932272 Bishopstown 934321 Blackpool 934054 Blackrock 933678 Blanchardstown 932515 Bray 933481 Buncrana 937290 Cabra 932280 Cahir 935042 Callan 933090 Capel Street 931101 Carrickmacross 932035 Carlow 933104 Carndonagh 937355 Cahersiveen 936030 Carrick On Shannon 937061 Carrick on Suir 935050 Carrigaline 934313 Cashel 935069 Castlebar 937088 Castleblayney 932426 Castleisland 936251 Castlerea 932558 Castletownbere 936278 Castletroy 930148 Cavan 932051 Celbridge 933503 Charleville 936189 Claremorris 937444 Clifden 937398 Clonakilty 936057 Clondalkin 933511 Clonmel 935379 Clonskeagh 931187 Cobh 934062 Cornelscourt 933392 Crumlin Road 931020 Dame Street 932086 Dingle 936286 Donegal Town 937304 Douglas Road 934348 Drogheda 932094 Drumcondra 932108 Dundalk 932450 Dundrum 933120 Dungarvan 934070 Dungloe 937339 Dun Laoghaire 933406 Dunmanway 936073 Edenderry 932469 Ennis 935387 Enniscorthy 933414 Ennistymon 935158 Fermoy 936081 Fethard 935395 Finglas 932132 Gorey 933643 Gort 937118 Grafton Street 931047 Greystones 933554 High Street,Kilkenny 933198 Kanturk 936316 Kells 932531 Kenmare 936324 Killaloe 935417 Killarney 936332 Killorglin 936340 Kilmallock 935212 Kilrush 935425 Kinsale 934089 Leixlip 933635 Letterkenny 937347 Lisduggan 934119 Lismore 934186 Listowel 935433 Longford 932140 Loughrea 937428 Lucan 933562 Lynch's Castle 937096 Macroom 936138 Mallow 936146 Manorhamilton 937134 Maynooth 933201 Midleton 934127 Millstreet 936154 Mitchelstown 936162 Monaghan 932477 Mullingar 932175 Naas 933236 Naas Road Business Bank 931004 Navan 932183 Nenagh 935220 Newbridge 933244 Newcastle West 935239 New Ross 933430 Portlaoise 933279 Raheny 932345 Ranelagh 931292 Rathdowney 933597 Rathfarnham 933295 Rathgar 931071 Rathkeale 935263 Roscommon 937142 Roscrea 935271 Salthill 937401 Sandymount 933600 Santry 932353 Shannon 935484 Skibbereen 936375 Sligo 937258 South Richmond St 931160 Stillorgan 933570 Swinford 937266 Swords and Malahide 932523 Tallaght 933317 The Quay 934275 Thurles 935301 Tipperary 935328 Tralee 936219 Tramore 934291 Tuam 937150 Tuam Road 937452 Tubbercurry 937274 Tullamore 932256 Tullow 933325 Western Road 934194 Westport 937169 Wexford 933341 Wicklow 933619 Youghal 934305

Referral Branch CM *

Select a Branch Capital Markets Business Banking 000017

Referral Branch BB *

Select a Branch Business Banking Branch Network 000015

Referral Branch CB *

Select a Branch Corporate Banking 930806

Referral Branch CE *

Select a Branch Customer Engagement Centre 930105

Hidden Referral Branch

Staff First Name *

Staff Last Name *

AIB Staff ID *

Staff Email Address *

Merchant / Company Information

Entity Legal Name *

Legal Status *

Select Legal Status Sole Trader Limited Company Partnership Charity Club/Society

Entity Trading Name *

First Name *

Last Name *

Business Address - (County) *

Select Business Address - (County) Antrim Armagh Carlow Cavan Clare Cork Derry Donegal Down Dublin Fermanagh Galway Kerry Kildare Kilkenny Laois Leitrim Limerick Longford Louth Mayo Meath Monaghan Offaly Roscommon Sligo Tipperary Tyrone Waterford Westmeath Wexford Wicklow

Preferred Contact Number *

Mobile *

All numbers including ROI, UK numbers must have a valid prefix (e.g. +353, +44)

Email *

Does the customer already have a website? *

Select an Option Yes No

Does the customer have a need for online payments? *

Select an Option Yes No

Description *

Submit