[text* fname class:form-control class:input-custom placeholder “First Name”]
[text* lname class:form-control class:input-custom placeholder “Last Name”]
[text* phone class:form-control class:input-custom placeholder “Phone Number”]
[text* email class:form-control class:input-custom placeholder “Email”]
Appointment details
[text* date1 class:form-control class:input-custom ]
[text* date2 class:form-control class:input-custom ]
[text* date3 class:form-control class:input-custom ]
[text* time1 class:form-control class:input-custom]
[text* autoinfo class:form-control class:input-custom placeholder=”Vehicle Year, Make and Model”]
I’m making an appointment for
[select select1 class:input-custom class:valid “Brake Inspections” “Air Filtration Services” “Cooling System Services” “Transmission Services” “Fuel System Cleaning”]
[textarea* message class:form-control class:input-custom placeholder=”Comments and Questions” ]
Maximum of 250 characters
[submit class:btn class:btn-lg “SUBMIT”]
Please note that the date and time you requested may not be available. We will contact you to confirm your actual appointment details.