Trial Application Form
CUSTOMER INFORMATION:
Company Name:
Contact Name:
Address:
 
City:     State:  
Zip:
Phone:       Fax:   
Email:
Years in Business:
   
MODEL INFORMATION:
SmartWasher Model Number:
Type of OzzyJuice:
 
OTHER INFORMATION:
In what department will the SmartWasher be used?  
What type of parts will be cleaned?  
How many parts washers are currently in use at this facility?  
What are your current parts washer related monthly expenses?  
What is your primary objective in changing parts washers?  
Who is your current parts washer source and/or hazardous waste disposal company?  
 
CUSTOMER RESPONSIBILITES:
1. Customer either purchases the SmartWasher or returns it to ChemFree after the Trial Period.
2. To return a machine, the customer must call to receive a Return Authorization number (RA#).
3. If necessary, Customer will thoroughly clean the SmartWasher prior to returning to ChemFree.  USED OZZYJUICE CANNOT BE RETURNED TO CHEMFREE.
4. Customer is responsible for return freight to ChemFree if not purchased.
5. Customer agrees to Business Credit Check by ChemFree.

BY PRESSING SUBMIT YOU AGREE TO THE TERMS AND CONDITIONS ABOVE.