Questionnaire

Type of Service:
Vehicle Make:
Near Your Location/Zip Code:
	from:
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Business Information

*Legal Business Name:

D.B.A. Name:

Owner(s) or Principals:

Type of Business:

Corp.
LLC
Sole Prop.
Partnership
Other

*General Manager's Name:

Business Location

*Shop Address:

*City:

*State:

*Zip:

Cross Streets:

Are you an off-site or mobile business and do not have a storefront?

Yes
No

*Phone Number:

Fax Number:

Website:

Email Address:

Mailing Information

My mailing address is the same as my business location

Mailing Address:

City:

State:

Zip:

Business Details

*Business Owners Since (Year):

*Number of Employees (excluding owners):

Business Certifications:

Secure overnight parking of customer vehicles?

Yes
No

Under what circumstances do you offer a loaner car?

Shuttle:

Rental:

Are you near public transportation points?

Yes
No

Do you operate a tow truck?

Yes
No

What's your towing policy?

*Hours of Operation: Monday through Friday:

*Saturday:

*Sunday:

Do any of your employees speak Spanish?

Yes
No

Do you offer any senior or AARP discounts?

Yes
No

If so, what is your discount?

Other discounts offered:

Customer waiting room

Customer restrooms

Are these areas always clean?

Yes
No

Other customer amenities:

Warranty policy:

Affiliation with parts house (etc.) that offers a nationwide warranty:

Are you a Better Business Bureau Member?

Yes
No

Are you a AAA Member?

Yes
No

Are you a Chamber of Commerce Member?

Yes
No

Other organizations:

*What credit cards do you accept?

Visa
MasterCard
American Express
Discover

Other credit cards/terms accepted:

*Services offered:

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Do you specialize in any particular products/services?

Have you won any awards, etc., for outstanding customer service or repairs?

Other information that you would like to have listed on the referral directory:

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By submitting this form, you agree to the following:
The information provided herein is correct to the best of my knowledge. We will continue to treat our customers in an honest and respectful fashion and keep our customer facilities clean and well maintained. We will advise YourAutoNetwork.com personnel of any customer lawsuits and complaints.