Sudz-Ez Service Provider Application Form

If applying for more than one location, please check this box.

Legal Business Name

Doing Business As (DBA)

if different than Legal Business Name

EIN

Employer Identification Number

Business Address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Business Phone Number

Phone Number of business itself

Business Contact Email

Email to contact business directly

First Name of Authorized Representative

Last Name of Authorized Representative

Position of Authorized Representative

Official role of Authorized Representative within the company

Email of Authorized Representative

Are your business hours the same for all Days of Operation?

Yes

No

For wash & fold services, do you charge by weight or by bag?

Weight (per lb)

Bag (flat-rate)