Driving Hope Car Maintenance Request Form

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Driving Hope Car Maintenance Request Form

By submitting this form, you are acknowledging that you will be responsible for paying for the parts required to repair your vehicle.

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* Indicates required question

Your Name *

Your answer

Phone Number *

Your answer

Email *

Your answer

Year, Make, and Model of Vehicle *

Your answer

VIN Number *

Your answer

Please describe the problem you are experiencing with your vehicle: *

Your answer

How did you hear about us? *

I attend Grace Ann Arbor

I was referred by someone at Grace Ann Arbor

Hesed Community Church

Friends Indeed

Website

Other:

How can we be praying for you?

Your answer

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