AMCRS Commercial Engineer Booking
Completion and submittal of this request form you are under no obligation to pay for any service/attendance charge until a booking has been attended. Once request received an AMC representative will contact you with an attendance time. AMC terms and conditions apply. All information/personal data submitted will be used solely by AMC Refrigeration and at no time passed to any third party. Please use this form for its intended use only.
Site Name
*
Business Name
Site Address
*
Street Address
Street Address Line 2
Town/City
County
Postal Code
Site Contact
*
First Name
Last Name
Site Phone
*
-
Area Code
Phone Number
Site Mobile
*
site contacts mobile number
Invoice Email
*
example@example.com
Company Name
*
Billing Company/Trading Name, if different from site name
Is the company billing address the same as the site address
*
YES (same as site address)
NO (enter the full company (head office) billing address)
Company Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Invoice Email
example@example.com
Accounts Phone Number
-
Area Code
Phone Number
Reported Fault
*
Single door Fridge
Double door fridge
Single door freezer
Double door freezer
Cold room
Freezer room
Wall chiller
Dairy cabinet
Counter display
Ice Machine
Ice Cream Machine
Bar cooler
Chest freezer
Other
Equipment type
Message/Fault Reported/Further information
*
Type your message
Submit a photo of faulty equipment (if available)
Purchase Order Number (if required)
Order Number
Your Name (person making request)
*
First Name
Last Name
Enter the message as it's shown
*
T&C's (tick box)
*
Terms and conditions and privacy policy read and accepted
Submit
Should be Empty: