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Vehicle Information
*
Make
*
Year:
*
Model:
Miles:
VIN Number:
Service Information
*
Type of Service Needed:
*
First choice for appointment:
Month:
January
February
March
April
May
June
July
August
September
October
November
December
Date:
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Time:
7:00 am
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
12:00 pm
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
Second choice for appointment:
Month:
January
February
March
April
May
June
July
August
September
October
November
December
Date:
1
2
3
4
5
6
7
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11
12
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14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Time:
7:00 am
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
12:00 pm
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
Third choice for appointment:
Month:
January
February
March
April
May
June
July
August
September
October
November
December
Date:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Time:
7:00 am
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
12:00 pm
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
Contact Information
*
Name:
*
Email:
*
Home Phone:
*
Day Phone:
Fax:
Preferred Contact:
Phone Morning
Phone Midday
Phone Evening
Email
Fax
*
Address:
City:
State:
Zip:
*
These fields are required
Subaru Stamford
198 Baxter Ave.
Stamford, CT, 06902
Phone: (203) 252-2222
Fax: (203) 252-2139
Email:
Customer Service