SERVICE, BODY OR PARTS SHOP RECOMMENDATION

Please specify:  Member  or Non-member:

Name:
Membership Number (if known and a member):
           

Your Email address:

Recommended Shop:

Name:
Street
           
City or Town
State or Province:
Zipcode or Postcode
Country (if not USA)
Type of business (repair shop, body shop or parts supplier):

Shop contact information:
    Business Ph.:
    Other/Cell Ph. (if any):
    Fax (if any): 

    Email address (if any):
    Website (if any):

other comments, shop specialty, etc.: