Service Request Form

Use the form below to schedule a Service Appointment at one of our locations. Remember to include as much information as possible when describing the items you would like us to address. A Service Coordinator will contact you within 24 hours of your submission (weekdays).

Required fields are indicated by an asterisk (*)

Customer Information
Location Where Service Is To Be Performed: *
First Name: *	Last Name: *
Address: *	City: *
State: *	Zip Code: *
Daytime Phone: *	Email Address: *
Prefered Contact Method: *	Best Time To Contact You:
Vehicle Information
Manufacturer: *	Make:
Model:	Year:
VIN:	Winnebago Serial Number:
Approx. Mileage (If motorized):	Approx. Purchase Date (mm/dd/yyyy):
Was It Purchased From Altmans Winnebago?	Have We Serviced This Vehicle Before?
Service Requested
Service Item #1	Item #1 Covered Under:
Service Item #2	Item #2 Covered Under:
Service Item #3	Item #3 Covered Under:
Service Item #4	Item #4 Covered Under:
Service Item #5	Item #5 Covered Under:
Additional Information
Additional Service Items:
Additional Comments:
Appointment Information
Requested Appointment Date (mm/dd/yyyy): *	Requested Drop Off Time:
Is There A Specific Date You Will Need Your Vehicle Returned To You?	If You Answered YES Please Specify The Date (mm/dd/yyyy):
If Possible, I Would Like To Wait For The Service To Be Completed?	Do You Live In Your RV?
PROMO CODE:
Yes, I would like to receive your e-newsletter

Altmans Winnebago

Service Request Form