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Bent Brewstillery Hand Sanitizer/Surface Disinfectant Inquiry Form
Hello, Please fill out this form to expedite your Sanitizer order.
Please read our FAQs:
HOW DO I PLACE AN ORDER?
- Fill out this inquiry form and we will contact you. Note: This form is to help us manage orders it IS NOT an online ordering system.

HOW DO GET MY ORDER?
-At this time we are unable to ship to you. After you place an order we will schedule an earliest pick up date. This date will be on your invoice. You will be able to get your order anytime on/or after the earliest pick up date.

*New Hours* Monday-Thursday 4PM-10PM, Friday 2:30-Midnight, Saturday Noon-Midnight, Sunday Noon-7PM. The address is on the invoice.

WHAT METHODS OF PAYMENT DO YOU ACCEPT?
- You will receive an invoice by e-mail.

- We are accepting two types of electronic payments. Your can use PayPal or pick the option to pay with your debit or credit card.

- We can accept various payment types and wire transfers from municipalities.

HOW SAFE IS THIS STUFF?
- Bent sanitizer is developed in accordance with the World Health Organization’s recommended formula.
- Here is our Material Safety Data Sheet: https://drive.google.com/file/d/1iZF9o5qB8Wgh7pbuBx67qG6vgAFjj7Dy/view?usp=sharing

PRICING: $20 for 1Gal. $100 for 5Gal. $825 for 55Gal. $3375 for 270Gal.

Surface Disinfectant 70% Ethanol $10 for 1Gal.

Reorders: To reorder email Jeremy and we will send a new invoice.

TIPS AND TRICKS:
- Save containers and refill them on the next purchase.
- Save containers with spray nozzles and pumps.
- Wipes: You can use a cloth in a ziplock bag to wipe surfaces as long as you keep it soaked
Name of Company/Organization/Personal: *
What kind of work does your company/organization do? *
Full Name: *
Phone Number: *
Email Address: *
Is this your first time ordering or a re-order? *
How much sanitizer/surface disinfectant are you requesting? *
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