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Full Name

Business Name

Business Website

Email Address

Phone Number

Type of Business

Number of Business Locations

Other Business Type

Are you currently using wipes?

Yes No

If yes, what brand, item number, or link are you currently using?

How many wipes do you currently use per month?

What types of wipes are you interested in? (Select all that apply)

Gym Wipes Heavy-Duty Cleaning Wipes Other

Other Wipe Types

What is your estimated monthly usage for wipes?

What are you primarily using wipes for?

How soon are you looking to order wipes for your business?

Comments / Special Requests (Optional)

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