Fibreglass Repair Request Form
Submit your production request for custom fiberglass components and repairs. Let us know your project details, and we'll bring your vision to life
Client Information
Name
*
First Name
Last Name
Contact Number
*
Email
*
example@example.com
Location
*
North Island
South Island
North Island Location
*
Please Select
Northland
Auckland
Waikato
Bay Of Plenty
Gisbourne
Hawkes Bay
Manawatu - Whanganui
Wellington
South Island Location
*
Please Select
Tasman
Nelson
Marlborough
West Coast
Canterbury
Otago
Southland
Project Details
Vehicle Make
*
Vehicle Model
*
Brand & Type of kit / Component
Project Reference (Optional)
Used for invoicing where required
Repair Details
Component Needing Repair:
*
Front Bumper
Rear Bumper
Side Skirts
Fender
Bonnet
Boot
Wing
Other
Type of Damage:
*
Crack
Split
Chip
Scuff/Scratch
Structural Damage
Other
Please upload images of damage
Please upload clear photos of the damaged area(s)
Browse Files
Drag and drop files here
Choose a file
10MB file limit - jpg, jpeg, png, gif, heic
Cancel
of
Repair Timeline
Do you have a timeline you need to meet?
*
Yes
No
Requested Completion Date
Additional Notes/Questions/Instructions:
Submit
Should be Empty: