REPAIR/CUSTOM JOB SUBMISSION FORM

PLEASE COMPLETE AS MUCH OF THE FOLLOWING INFORMATION BELOW BASED ON THE INFORMATION YOU HAVE AT THE TIME OF SUBMISSION. YOU WILL BE ABLE TO UPDATE THE INFORMATION LATER ON IN THE PROCESS AS WELL

IS THIS A REPAIR OR A CUSTOM JOB? *

EMPLOYEE NAME *

Customer First Name *

Last Name *

Phone

Address

Street Address

City

State

Country

Postal code

Repair/Custom Job # *

Image of the job with envelope filled out

Please make sure you include any needed details in the photo. This photo will be used to record the job and notify the customer that the job was received

Repair/ Custom Job Descriptions *

Need To Confirm Job estimated cost before moving forward?

Who is doing the submitted job? (if already known)

Shipping

Repair Charge

Yes