ScrubaDub Auto Wash Centers

 Name of Contact Person
 
 Name of Organization                                     
 
 Street Address
 
 City                                            State     Zip Code
 
 Telephone                        Email Address
          
Non-Profit Id#


Number of Express Wash coupons needed: 0 50 100 150 200 250 300 350 400 450 500 550 600 (Raise about $4.25/wash)

Number of Works Wash coupons needed:  0 50 100 150 200 250 300 350 400 450 500 550 600 (Raise about $8.50/wash)

Desired start date of program: (Program runs for a maximum of 30 days)


Closest ScrubaDub location to where you will be selling your tickets
Closest Location Natick Brookline Roslindale South Bay Woburn Marlboro Shrewsbury Park Ave, Worcester Grafton St, Worcester Shrewsbury St, Worcester Warwick, RI Salem, NH Portland, ME Biddeford, ME South Portland, ME

Please tell us about your group and the purpose for raising funds.

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