Fleet Account Signup Form

You can fill out the online forms below to sign up your business or organization for a Fleet Account. Fleet Accounts are billed at the end of the month. A 5% discount is allowed on balances up to $100 per month and 10% for balances over $100.   After filling in the form, come in to Clean Choice to pick-up your card(s).

Or, if you prefer, you can print out a PDF version of the form and fill it out by hand before you bring it in to Clean Choice.

  1. (required)
  2. (required)
  4. (required)
  5. (required)
  6. (required)
  8. (required)
  10. Please Enter the names/vehicle numbers of the users on this account:
  12. Designation
  15. Designation
  18. Designation
  21. Designation
  24. Designation

  26. Terms & Conditions

    • Payment in full within 10 days of receipt of Clean Choice invoice.
    • All legal fees, court cost and collection fees to be paid for by account holder on the event of default to terms of contract.
    • Interest will be paid to Clean Choice, by account holder at the rate of 2% or maximum allowed by law. Minimum $30.00.
    • The account holder hereby gives permission to disclose information to be used in granting open terms.
    • All wash cards distributed, remain the property of Clean Choice and must be surrendered when requested.
    • A 5% discount is allowed on balances up to $100 per month and 10% for balances over $100.

    Acceptance of terms & conditions

         
    Authorized Signature Title Date
 

cforms contact form by delicious:days

© 2009. Clean Choice Car Wash. All rights reserved.