EmailMe Form - DJ's Marine Service Request Form

Name *

First Last

Email *

Confirm

Phone *

### - ### - ####

Mailing Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Watercraft location (Marina or Yacht Club)

Slip or dock Number Or letter

Boat length in feet and inches *

Watercraft or Equipment Manufacturer

Model name or number

What year is your watercraft or equipment

propulsion system

Engine Manufacturer Horsepower and Year

Do you know how much fuel is in the tanks and what the capacity is

Name on the back of the boat

Valid Registration Letters and Numbers *

We are not responsible for Electronics or any other items left in or on any boat at our shop for service or storage. Make sure these items are removed initial below *

Key Location is Required! This is very important service calls without keys are subject to one hour mobile fee no exceptions. *

A valid Credit Card must be on file with the office before we can order parts or provide services we will contact you after the service request has been received. Please Initial Below. Do not add Credit card information here *

All requests for service will authorize DJ's Marine Personnel to board and operate your vessel. Customer will agree to pay the minimum mobile fee of $135.00 Please initial the field below *

Unless otherwise stated or discussed with management there will be a 9% interest charge per month starting after the first 5 day grace period on completed billed services and a $35 a day storage fee for Boats not picked within 5 business days. Please Initial the field below *

Boats at the shop for storage. Year round Insurance is required. Please add your insurance information here or make arrangements with the office *

Services Requested or Special instruction *