Lodge A Service Request

Lodge A Service Request

• Firstname*
• Lastname*
• E-mail Address*
• Site Contact Number*
• Business Name*
• Business Street*
• Business City / Suburb*
• Buisness State*
• Postcode*
• Phone Number
• Make and Model of Product *
• Please Enter The Supplier / Brand *
• Serial number
• Invoice number
• Where did you purchase from?
  -- Please Select --Sunshine ShowroomDandenong ShowroomOnline
• Approximate Date of Purchase
  
• Description of Problem
• Preferred Date of Service
  
• When is the service required?
  -- Please Select --After Hours (5pm - 9am)Business Hours (9am - 5pm)
• Please specify preferred time (optional)
  -123456789101112 : -01234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 AMPM
• Additional comments
• Please upload any additional information (max. 3mb)
  Choose File No File Choosen

  Allowed file extensions to upload: png,docx,jpg,pdf

• *Disclaimer
  • I agree to the Terms and Conditions laid out by DCE and it's affiliates.