Chipping Sodbury Motor Company


Online Service Booking Request Form

Please note that this form is made available only for the convenience of online customers and completion of the form does not constitute a confirmed booking. 
Upon receipt of an online request, our customer service team will contact you by telephone to confirm your booking and individual requirements or to offer alternative arrangements.
This form should only be used for booking request dates at least 10 working days from the date shown below. 
Should you require more immediate service then please call the service desk on 01454 310136.
(View Terms and Conditions)

This request timed at: 

(All fields marked with a * must be completed)
Name:

Salutation

   (Mr/Mrs/Miss/Ms/Other)
  First Name *      
  Last Name *      
Address: House Name/No

*
Street Name *
District
Town *
Post Code *
  Daytime Tel *    
  Email *      
Car Details: Make *(e.g. Ford)
  Model *(e.g. Focus)
  Reg No *
  Year *
  Engine Size *(e.g. 2000cc or 1.8 etc)
  Engine Type Petrol

Diesel*        (Other type? - please phone)
  Mileage *(e.g.  20,000 approx)
Booking Request:

Please tick all that apply - specify any specific
service or repair requirements in the box to the right.
 

  Service

    

     
  MoT

    

  Repair Work

    

  Preferred Booking Date *
  Alternative Booking Date *
(Dates must be at least 10 working days from today)
  Courtesy Car Required? Yes No

(Subject to status and availability.  Please note that a nominal fee of £10 will be charged - see notes)
Collection/Delivery
Required?		 Yes No (max 10 mile radius)
Please check your entries carefully.
Click here to read our online forms terms and conditions.
Click on the button below to print this form for your records and/or to 
print the form if you would prefer to fax the request to us on 01454 325607
* I have read and agree the terms and conditions as stated