Stock Lift:

Dealer Name:	*
Dealer Email:	*
Customer Name:	*

Customer Phone Number: *
Home:
Cell:

Customer Email Address:

Lake Customer is located:

Customer Mailing Address:
Street:
City:
Zip:

Customer Lake House and/or Community Dock Address with slip #:
Street/Lot #:	*
City:	*
State:	*
Zip:
Slip #:

Type of Boat: *
Pontoon:
Tri-toon:
V-Hull:
Other (please describe):

Does customer see themselves purchasing a larger boat in the future?
Y	N

Do you want to pick the lift up, have it shipped, or have it installed by one of our factory teams? *
	Pick Up
	Delivered
	Factory Installed

And when do you need it by?
Date:	*
When you receive your order confirmation we will confirm that your lift will or will not be ready by the date you provided above.

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