Independent Distributor's Application
Sponsor's Name & I.D.#
Pin :
Applicant Information
*
Required Field
* Name of Primary Applicant:
Name of Secondary Applicant:
* Mailing Address
* City, State, Zip Code
* Phone Number
* Business Phone/E-mail:
Shipping Information
(If different from mailing address)
Shipping Address
City, State, Zip Code
Business Information
Company Name
Federal ID or Tax #
You have the right to cancel this agreement at any time regardless of reason by sending
written notice to the Everlasting Waterless Car Wash Home Office. Appli
c
ation fees are
refundable withing two weeks of the application date. Outstanding balances may apply. By
submitting this application, I affirm and attest that I have read and understand the terms and
conditions of this Independent Distributor's Application and agreement.
