Standard Partner Application Form

Standard Meridian Partner Endorsement Application

The Meridian Partner Endorsement requires a third party risk assessment. Please complete this form to initiate your thorough review, and you will be contacted by a Meridian representative within 24 hours of your submission to outline next steps. Partner screening and endorsement will be complete and you will be notified of the outcome within 45 days of your submission.

Organization Name*
Organization Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Description*
Please your organization and it's services, to include your intended client/consumer. 500 characters maximum please.
Representative Name*
First Last
Title/Position
Services Offered*

Please list your services by short title or description.
Representative Phone Number*
Representative Email*
Enter Email Confirm Email
Organization Website*
Referring Affiliate Name (optional)