Milltown Marine Service Customer Intake Form

CONTACT

Name on the invoice *

Address *

Contact Name *

Telephone *

Email *

Confirm Email *

VESSEL

Power or Sail *

Power *

Sail *

Boat Name *

Manufacturer *

Length *

Model *

Year *

Colour *

ENGINE

Engine Brand *

Inboard or Outboard *

Inboard *

Outboard *

Single or Twin or Triple *

Single

Twin

Triple

Gas or Diesel *

Gas

Diesel

Kicker? *

Yes

No

LOCATION OF VESSEL

Location *

Milltown Marina Client *

Yes

No

Slip # / Marina Account # *

External Clients Coming By *

Trailer

Water

Notes

Location of Keys *

Will Use Drop Off Box *

Yes

No

Drop Off Date *

Scope Of Work Required *

Thank you for submitting your request. We will get back to you ASAP.

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