Panelcare - Repair Enquiry


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	Repair Enquiry Form


	Panelcare (Rochdale) Ltd Lawton Street Rochdale OL12 0LQ Tel: 01706 639007 Fax: 01706 651520 sales@panelcare.com

Repair Enquiry Form

Name:

Address:

City:

Postcode:

Tel:

Mobile:

Email:

Brief Description of Damage:

Please use the colour map provided below to identify which areas of the car need repair work and then tick the applicable boxes.

Green		Yellow		Light Blue		Pink		Brown
Orange		Red		Dark Blue		Purple