CARZ R US APPOINTMENT REQUEST FORM

APPOINTMENT REQUEST

Carz R’ Us 10208 Smythe Ave Machesney Park, IL 61115 (815) 877-4277
Preferred Day(s)*

MondayTuesdayWednesdayThursdayFriday
What time would work best for you?*

MorningAfternoon
Reason for appointment*

Oil ChangeRepair
*Reason for Appointment

Vehicle Pick Up
Minimum charge of $100 for any pick up appointment
Do you want us to pick up your vehicle?*

YesNo
Do you need your vehicle picked up at home or another address?*

Home AddressOther
If other, what is the Pick Up Address?

Street Address

Street Address Line 2

CityState

Zip Code
Additional Information: (Parking Lot Location, Garage Code, Gate Code, Etc.)
Keys Location: (Please place keys above the visor) if placed differently please note here: