Online application for Unlimited Wash Pass purchase

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Name:
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Phone Number:

Mailing Address:
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Unless otherwise indicated the gift certificate will be sent to the purchaser’s address
Enter billing address for credit card if different from above
click here if billing address is the same
Billing Address:
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zip
Name On card:
Check one:
express 6 month ($119.70 total)

express 12 month ($239.40 total)

silver 6 month ($179.70 total)

silver 12 month ($359.40 total)

total payment
credit card (secured server)
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expiration

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"Your Car Wash Professionals"

Magic Wash
578 Mill Creek Road
Manahawkin, NJ 08050

(609) 597-SUDS
Fax: (609)597-9427

Serving LBI and the Mainland since 1983


www.magiccarwash.com




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