Milltown Marine Services
Date
First Name *
Last Name *
Name on the Invoice (if different)
Address
Cell Phone *
Home Phone
Email *
Are you an existing Milltown Marine Services Customer?SelectYesNo
Are you an existing Milltown Marina customer?SelectYesNo
Account Number (if known)
Drystack or In WaterSelectDrystackIn Marina
Dock #
Current Location of Boat
How will you be delivering your boat to us?SelectTrailerWater
Power or SailSelectPowerSail
Boat Name
Builder/Manufacturer
Model
Year
Length
Colour(s)
Inboard or OutboardSelectInboardOutboard
Single, Twin, TripleSelectSingleTwinTriple
Size of Engine
Engine Manufacturer
Year of Engine
Serial Number
Size of Engine #1
Engine #1 Manufacturer
Year of Engine #1
Serial Number #1
Serial Number #2
Serial Number #3
Gas or DieselSelectGasDiesel
Do you have a Kicker?SelectYesNo
Make/Model
Serial #
Will you use our Key Drop Off Box? (secure drop box near front door)SelectYesNo
Drop Off Date
Would you like us to clean your boat?SelectYesNo
Check all that apply.
InsideOutsideAbove WaterBelow WaterPressure WashScraping Marine Life RequiredBasic (1-4 Hours)Detailed (4+ Hours)
Other Comments
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