PROLINK DISPENSER PROGRAM – DISPENSER BUILD FORM

1. Check off 1 Product per quadrant. Choose only 1 product per section. (i.e. PolVita Restroom instead of Enzysan2000 for top right quadrant)
2. Fill out the information below, including Distributor, Sales Representative Name, and Name of Account.
3. Submit to Melissa Remington by email at mremington@cleaneasier.com or fax at 207 856.0001
**Note: Build form MUST accompany an order of 1 case per product, per dispenser, to qualify for free dispenser and wall chart