Express! Solutions Sample Request Form

Request A FREE KleenBrite™ Liquid Car Wash Soap Sample

Note! All information is held strictly confidential - we will never sell your information!

To receive your free sample of KleenBrite™ Super Concentrated Liquid Car Wash Soap, fill out this form or call 563-299-0144.

The only requirement will be that you fill out a simple survey, which will be sent with the sample, evaluating the soap and return it after using the soap.

We appreciate any and all correspondence related to the operation of car washes and the chemicals used. Helping you service your customers in the most efficient way is what we are about. Thank you for your time.

Please note: Free sample offer is only valid for commercial carwash owners!

Business Name (required)

Contact Name (required)

E-Mail (required)

Shipping Address (required)

City (required)

State (required)

Zip Code (required)

Phone (required)

Cell (optional)

Fax (optional)

URL (optional)

How many car wash locations do you own or operate (optional)

Do you use a liquid or powder soap? Powder Liquid Hybrid (combination) Please select your type of soap

Are you satisfied with the performance of your soap? Satisfied Somewhat Satisfied NOT Satisfied Please select your satisfaction level of your current soap.

Do you feel you are paying to much for Soap? Way too much Pricing is O.K. Great pricing Please select how you feel about your curent soap costs

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To fax or mail your request in writing,Click Here for a Printable form.

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