Application FormPlease enable JavaScript in your browser to complete this form.Which option are you applying for? * Become a Distributor for ChemQuest Inc. Become a Customer (End User) Which ChemQuest representative have you been in contact with? *Adam KeeneRyan VossenAlex WhaleySteve FoxSteve GirardDo you sell and svc equipment? Yes No Which Brands?Do you sell and svc chemical? Yes No Which Brands?Do you own and operate washes? Yes No Do you own and operate washes? How many washes do you own?What kind of Car Wash?AutomaticTunnelSelf-ServeTruckWhich brands of equipment are used?Which brands of chemicals are used?What is your current chemical discount?Why do current customers buy from you?What kind of infrastructure do you have? (Select all that apply) Warehouse Delivery Trucks Employees Dedicated to Chemical What was your total chemical buy last year? *How do you see ChemQuest helping you grow?What are your expectations for ChemQuest? *Why us? Why choose ChemQuest? *Submit
