:
Service Form
Please complete the following fully:
Name
Title
Mr
Mrs
Ms
Address
Work Phone
Home Phone
Car for service or repair
Email
Reg No.
Make
Model
Year
( Please allow 48 hours for booking )
Date for Service :
dd/mm/yy
dd/mm/yy
1st choice
2nd choice
Do you require a replacement car ?
Which service option would you like:
Lubrication Service
6000 - 9000 mile service
12000/18000 mile service
Holiday Winter Check-up
NCT-pre-test
Insurance estimates
Please specify any other repairs or work you require:
Method of Payment:
Cash
Cheque with Bankers Card
Credit Card
Account
Account Number:
Please indicate one of the following options :
Email/telephone me with a confirmed appointment
Email/telephone me with a quotation
Contact me for help and advice
O'Mara Motors
Ennis Road, Limerick
Tel: +353 61 451611 - Fax: +353 61325267
email:
info@omaramotors.com
