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CounterAct is available from local agents or should we not have representation convenient to your location you may purchase directly from us. Since we make such a wide variety of anti-corrosion systems for everything from ATVs to Aircraft we want to insure that you obtain just the right system for your purpose. Before purchasing please complete the form below and e-mail it to us so that we can assist you in finding just the right CounterAct system for your vehicle.
In addition to using this form you may choose to e-mail us at: counteract@counteractrust.com
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(NOTE: Please provide us with all the necessary information to address your specific inquiry and reply to your request.
Your name, city, state or province and e-mail address are required in order for us to reply to your inquiry or refer you to a local CounterAct agent.)
Required fields are marked with an asterisk *
Please use this form to receive our recommendation about the correct CounterAct system for your particular needs and to learn the location of your nearest CounterAct agent. We will respond at our earliest opportunity with recommendations and pricing. Additionally you may contact us at counteract@counteractrust.com or call us toll free.
| Name | * |
| Title | |
| Organization | |
| Street Address | |
| Address (cont.) | |
| City | * |
| State/Province | * |
| Zip/Postal Code | |
| Country | |
| Phone | |
| Cell_Phone | |
| Best Time to Call | |
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| URL |
I am inquiring about a CounterAct system for:
My vehicle make/equipment manufacturer is:
My vehicle/equipment model and year of manufacture is
My vehicle/equipment is exposed to one or more of the following conditions:
driven high miles
Used in Snow removal
high heat and humidity
proximity to ocean or beach
off road use
commercial or work use
carries corrosive materials
You may be eligible for one of CounterAct's standing discounts. Are you a member of one or more of these groups?
AAA
AARP
Active Duty U.S. military
Branch
Duty Station
Rank
Repeat CounterAct customer
Place of Purchase Date of Purchase
CounterAct offers discounts to Police and Fire Depts. as well as many government and non-profit groups. If you are purchasing for the use of one of these groups please indicate below and list your organization and title in section 1 of this form
Police or Fire Dept.
government, municipal or non-profit entity
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