FOR OUR EARLY BIRD OR LATE EVENING SERVICE CUSTOMERS

1.  WRITE YOUR ORDER ON THIS FORM
2.  LEAVE YOUR VEHICLE ON THE SIDE OF THE BUILDING AND LOCKED.
3.  PLACE FORM - KEYS - SERVICE COUPONS IN THE ENVELOPE
(Envelopes are inside the early bird box)
4.  DROP ENVELOPE IN THE SLOT

Name:  ________________________________________________     Lic. No.  ________________________

Address:  __________________________________________________________________________

City:  ___________________________________________________    Zip:  _____________________

Home Phone:  _______________________________    Work/Cell Phone:  ____________________________________

Email:  ___________________________________________________  Mileage:  _______________________________

Year:  ___________________     Color:  _________________      Make & Model:  ________________________________

Where should we contact you?  ____________________________________  By Phone or Email?  ________________

USE THIS HANDY CHECK LIST

__________  Mileage Inspection     __________  Mile Diagnosis     __________  Alignment     __________  Tune Engine

__________  Change Oil, Filter & Lube     __________  Replace Muffler     __________  Change Transmission Oil

__________  Check Engine Light Illuminated     __________  Repair Lights     __________  Fluid Leak Under Vehicle

__________  Reline Brakes     __________  Adjust Brakes     ___________  Replace/Adjust Clutch

__________  Runs Bad or Stalls     __________  Check Belts & Hoses     __________  Replace Battery

Other Work (Please provide as much detail as possible)  __________________________________________________
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I hereby authorize the repair work herein set forth to be done by you, together with the furnishing by you of the necessary parts and other material for such repair, and agree:  that you are not responsible for any delays caused by unavailability or delayed availability of parts or material for any reason;  that you neither assume nor authorize any other person to assume for you any liability in connection with such repair;  that you shall not be responsible for loss of or damage to the above vehicle, or articles left therein, in case of fire, theft or other cause beyond your control; that an express mechanic's lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto; that your employees may operate the above vehicle on streets, highways or elsewhere for the purpose of testing and/or inspecting such vehicle.

PLEASE SIGN HERE:  ___________________________________________________________________