Phone:(419)-898-0483

Fax:(419)-898-4025

fixthisboat@gmail.com


Service Request

Please fill out the following form if you would like us to perform service on your vessel.  This form must be filled out by all customers who are unable to travel to the shop and fill out a form in person. 

You will receive a phone call before any service is preformed.  The credit card provided on this form will be used to pay the invoice for all services rendered.  A valid credit card number MUST be provided before any dockside service can be performed (this may be provided in person or over the phone instead of submitting on-line).  Alternative payment methods will be considered, but contact must be made with Mobile R.V. before the work is started.

Thank you for your business and we look forward to providing all your service needs.

First Name:
Last Name:
E-Mail:
Phone No.:
Cell No.:
Address:
City:
State:
Zip:

Please choose where we will work on your vessel:
I will bring my vessel to Mobile R.V.:
Mobile R.V. needs to perform dockside service:

Payment Information:
Type of Card (Visa, MC, Discover):
Card No. (no spaces):
Exp. Date (Mo/Year):
Security Code:

Please list your problems and leave any additional comments
Comments:

By checking this box, I agree to allow Mobile R.V. & Marine LTD to contact me about performing service on my Recreational Vehicle or Marine Vessel.
I Agree to Mobile R.V.'s Terms of Service:

 

Submission Security

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