New Customer Form

Rogers' Northside Garage New Customer Form

Company Name:
First & Last Name:*
Spouse:
Address:*
City, State, Zip:*
Home Phone:
Work Phone:
Cell Phone:
Fax:
Other:
Email:
How Did You hear About Us?:
Please elaborate, what phone book, site, friend's name etc.?:
Verification No.:*
contact form faq

“Rogers Northside Garage Privacy Policy. It is the policy of Rogers Northside Garage to use personally identifiable information collected to from you to complete transactions initiate by you. We may use identifiable information to contact you to make sure you are satisfied with your services or to find out how we can serve you better. You may, from time to time, receive information from us regarding new services and special offers we think you’ll find valuable. You will also receive a quarterly newsletter. If you would like to opt out of receiving e-mail or additional follow-up please tell your service advisor. Thank you Roger’s Northside Garage.”

Please print this form and bring it in at your appointment or submit online and a service advisor will contact you as soon as possible.