1

MobileWash Washer Registration

Provide your information below.

FIRST NAME

LAST NAME

EMAIL ADDRESS

PHONE NUMBER

STREET ADDRESS

SUITE/APT # (OPTIONAL)

CITY

STATE

ZIP CODE

2

Professional Information

Provide your information below.

DRIVER LICENSE

UPLOAD IMAGE

PROOF OF INSURANCE

UPLOAD IMAGE

ARE YOU LEGALLY ELIGIBLE TO WORK IN THE U.S.?

DO YOU OWN A VEHICLE AND MOBILE AUTO DETAIL EQUIPMENT?

DO YOU HAVE WATERLESS CAR WASH PRODUCTS?

WHAT AREAS WOULD YOU PREFER TO OPERATE IN?

WHAT IS YOUR PREFERRED WORK SCHEDULE?

ARE YOU OPERATING AS A BUSINESS OR INDIVIDUAL?

NAME OF COMPANY

HOW MANY YEARS OF CAR WASH EXPERIENCE?

 I agree to MobileWash's Terms of Service