Company Discounts Form

Fill out the enrollment form below to sign up for your company discount.

A representative will contact you within one business day to discuss your company discount.

Fields with * are required.

Discount Structure works as follows:

Minimum 10 employees = 10%

11 - 25 employees = 15%

26 - 50+ employees = 20%

Visit www.drysolv.ca!

Corporate Head Office
2nd Floor - 426 Portage Ave.
Winnipeg, MB R3C 0C9
phone: 204.944.0590
fax: 204.943.0211
email: dollarwise@mts.net

Company Name: *
Contact Name: *
Phone Number:
Email: *
Number of Employees: *
Employee Names	Fill this section in with your Employee Names and we will create Discount Cards and deliver them to you!
Name of Referrer (who did you hear from?)
Comments/Questions: