Directions |
Welcome
to Jack Safro Lincoln Mercury in Oconomowoc, Wisconsin.
Jack Safro
Lincoln/Mercury Service Appointment Form
| Customer
Information: |
Full
Name:
|
Street
Address:
|
City:
|
ST/Province:
|
ZIP/Postal Code:
|
Home Phone:
|
Work Phone:
|
E-Mail:
|
|
| Vehicle
Information: |
Year:
|
Model:
|
License Plate
#:
|
Mileage:
|
Please be as
accurate as possible. |
|
| When
would you like to have your vehicle serviced? |
| Drop off |
Month/Date:
|
Time:
|
| Pick up |
Month/Date:
|
Time:
|
|
| If
we are unable to accomodate you on the abovedate, what is your second choice? |
| Drop off |
Month/Date:
|
Time:
|
| Pick up |
Month/Date:
|
Time:
|
|
| Scheduled Maintenance |
|
|
Or
describe the service you wish to have performedbelow:
|
|
| How
would you like us to confirm this appointment? |
| Work
Phone |
Home
Phone |
E-Mail |
| Best time to
call: |
|
Please note: this form
must be filled out completelyin order to properly set your service appointment. |
Comments:
|
|
|
PLEASE CALL (800)564-5574
with any other questions
OR E-MAIL fordservice@safro.com
Jack Safro Lincoln
Mercury
1000 East Summit Avenue
Oconomowoc, WI 53066
1-800-564-5574
e-mail : lincmerc@safro.com
|
