Oxford Car Wash Fleet Account Application
4088 S Federal Blvd, Sheridan, CO 80110
Ph: 303-781-4940
Fax: 303-471-0255
Email: robcube@gmail.com

Company Details

Company Name: _________________________________________________

Contact Name:  _________________________________________________

Phone Number:  _________________________________________________

E-mail:_________________________________________________________

Address: _______________________________________________________

             _______________________________________________________

City:      __________________________   State: ______  Zip: __________

Credit Card Details

Credit Card:  [ ] Mastercard    [ ] Visa

Credit Card Number:________________________

Expiration Date: ____/____

Business Details

How long have you been in business?  ___ (in years)

How many vehicles?  ____

Types of vehicles (check all that apply)   [ ] semi   [ ] trucks/vans    [ ] cars    [ ] trailers

Account used for?   [ ] automatic    [ ] self-serve    [ ] both


Name three references (if not pre-paid)
Name & phone required

1:________________________________________________________________________

2:________________________________________________________________________

3:________________________________________________________________________