Detailing Fill Out Form

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Name *

Phone Number *

Vehicle

Car

Truck

SUV

Suburban

Van

Other:

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Package *

Interior

Exterior

Full

ONLY FILL OUT IF YOU CHOSE: *Full*

Which after Polish would you like to be applied

Quick Ceramic Coat Spray & Wipe Down ($20)

Complete and Full Exterior Wax Buff ($50)

None

Clear selection

Service Location *(Other Location will have Travel Fee)* *

My Location (20613 Laramie Rd Elkhorn NE 68022)

Other:

Payment *

Cash

Check

Venmo

Paypal

Agreement for Cancellation Fee? ($10)(Reschedules Exempt) *

Yes

Required

Agreement that pricing may change depending on excessively dirty vehicles? *

Yes

Required

Permission to contact customer about appointment? *

Yes

Required

Special Requests or Concerns? (MUST PUT SOMETHING FOR ME TO LOOK AT IT)(Example: "Stay out of Center Console" "Odor" etc...

Add-Ons

Headlight Restoration ($50)

Tire Shine ($10)

Exterior Trim Restoration ($15)

Monthly Maintenance Plan (Discount)

Odor Bomb ($15)

Social Media Post (Post on your socials and get a 10% discount!!)

How did you hear about Prime Shine?

Would you like an Invoice?

Yes

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*DISCLAIMER* While every effort is made to improve your vehicle’s appearance, detailing services do not guarantee the removal of all stains, odors, scratches, paint defects, or permanent damage. *

I Understand

Required

*PHOTO ALBUM*

https://drive.google.com/drive/folders/19VYkJZPa98y3wHvAzsJYaSUEUqTaLI3a

Option 2

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