Car Wash Order Form
Please complete as much of the Order Form as possible, then press the PLACE ORDER button.
Contact Name: *
Company Name: *
Billing Information: * required fields
Name: *
Address: *
City: *
State: * Zip: *
Phone: * Fax:
Cell:
Email: *
Type of Card: None Visa Master Card Discover American Express
Card Number:
Expiration Date: Month January February March April May June July August September October November December Year 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
3 digit security code from back of card:
Shipping Information (if different than 'billing')
Contact Name:
Company:
Address:
City:
State: Zip:
If you would like us to reference your P.O. Number or Site Reference for this order, key here:
SIGN PACKAGE
Includes: 2 Change Mat Menus,
12 (L-bent) Pump Menus,
1 Activation Menu, 1 Cashier Store Menu and 4 Employee Badges
Sign Package(s):
Components are Custom to Your Site with a Fast Turnaround Time
Click on item for a picture example and description. Use your browser's 'Back' button to return to this page.
If you are ordering Menu signs, please complete the following:
Brand Name:
Location Identifier:
Existing BDI Clients do not need to fill out this information again. All we need is your BDI Reference # (located at the lower left of existing signs) then you can 'PLACE ORDER' with the button located at the bottom of this page. Reference #:
Please key the Wash Names, specific options, and Prices for Tier 1, Tier 2 and Tier 3 washes by hi-lighting and keying over the pre-filled information. Any pre-filled information that you choose not to use should be deleted. When finished keying all necessary information, press the PLACE ORDER button.
Additional items, such as 4th wash column, can be added in the 'Special Instructions or Requests' box at the bottom of this page.
We prefer that information is keyed on this form and submitted electronically. Other options are to fax in a legible copy of your existing menu with changes noted, email a digital picture, or fill out the printed form and fax to us. BDI fax number is 515-986-9073.
Tier 1 Wash Name
Price:
Tier 2 Wash Name
Tier 3 Wash Name
Type of Car Wash Rollover Car Wash Conveyor Car Wash Touch Free Car Wash
Shipping Preference Ground Overnight Express Two-Day Air
Please Select a
Menu Type:
Standard Menu
Vertical Menu
Table Menu
Custom Menu
Please key your Special Instructions or Requests here:
For example: discount with gas purchase, 4th tier wash options, specific colors, brand name, or to highlight wash (e.g. "Best Value" starburst)
Other Custom Signs are Available! Call 515.986.9111 for Details!
