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Spring Request Form
A 50% Deposit Is REQUIRED To Reserve
Your Spot On The Schedule!
Captain's Orders Has My Credit Card Number On File.
Please Have The Captain Call Me For My Credit Card Number.
 Do Not Place Your Credit Card Numer In Your Request


 * Required Item
Name:*
Email:*
Address:*
Address 2:
City:*  State:*  Zip:*
Home Phone:*
Work Phone:
Fax:
 My address and or phone has changed Yes No
Make/Model/Year/Name of Boat:*
Boat stored where?*
Boat key is where?*
Haul Date:
Boat Length:

Sign me up for:
 
Remove Shrinkwrap
Recyle Kit
Rub/Wax Hull Only
Rub/Wax Topside Only
Rub/Wax Complete
Reconnect Batteries (batteries are on my boat)
Pressure Wash Bottom
Acid Wash Bottom
Bottom Paint
  Black    Blue    Red    Other
De-winterize
Install Batteries (Captain's Orders has my batteries)
 
 
Haul My Boat From Captain's Orders:
To The Marina Listed Above
To Lakes Of The Four Seasons
To Shorewood Forest
To Flint Lake
To Other


Please use the space below for any
questions or any other information you may have for the Captain.

Please add me to your mailing list:
  Yes    No  





Captain's Orders, Inc.
2058 Joliet Road
Valparaiso IN, 46385
219.531.CAPT (2278)
Fax 219.531.2998
Orders@CaptainsOrders.com



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