Lake Lure Marine ~ Service Request Form 2022

First Name *

Last Name *

Boat Location *

Dock and Slip # or House Address *

Shop Services - All performed at the shop except haul out

Please Summarize Symptoms for Diagnostics/Repair

Boat Key Location: *

Boat Year, Make, & Model *

Engine Year, Make, & Model/Serial Number - (Serial Number required for custom estimates)

Trailer VIN or Detailed Description including color, manufacturer, etc

Preferred Date Request: We will always accommodate when possible, however, due to weather and scheduling the requested date is not always available. Please note our mobile schedule normally runs 2-3 days a week in peak season. * +

Phone Number *

Email Address *

NOTE: Not all services can be performed on the lake. Please fill out the form with your requests and we will get back to you if there are any issues and to confirm scheduling. Thank you ~

Please enter your credit card number in the secured box below. Invoices not paid in a timely manner will be charged with the card on file. All credit card charges will have a 3.5% processing fee added. All invoices must be paid before boat is returned.

Name on Card

Credit Card Type

Credit Card Number

Expiration Date (mm/yy)

CVC Code

Billing Zip Code

Itemized estimate requested?

YES

NO

Please sign your work order request. Once submitted we will receive an email with your request & add it to the schedule. *

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Please check the box below to submit request *

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