Company *

Contact First Name *

Contact Last Name *

Contact Email Address *

Facility Address *

City *

Country *

Zip /Postal Code *

Contact Phone # *

Shop Specialty *

TrailerTruckBus/Specialty

Facility Labor Rate *

Primary WABCO Distributor/Supplier

Secondary WABCO Distributor/Supplier

Does your facility have an OEM affiliation?

YesNo

OEM Affiliation, please identify company(s)

What is your OEM Labor Rate?

Comments

How many full-time technicians on staff? *

Number of service bays *

Shop Size (sq ft)

Yard/Lot Size

Does your facility have lifts on premise? *

YesNo

If so, how many lifts?

Does your facility have pits on premise? *

YesNo

If so, how many pits?

Do you have WABCO's TOOLBOX software?

YesNo

Are you willing to share WABCO specific repairs with us?

YesNo

Facility Repair Capabilities - Specialty Repair

Facility Owner/General Manager *

Job Title/Position

Company Phone

Email *

Facility Type

Shop Supervisor First and Last Name *

Shop Supervisor Title *

Shop Supervisor Email Address *

Shop Supervisor Phone Number *

Finance Contact First and Last Name *

Finance Contact Email Address *

Finance Contact Title *

Primary Facility Contact First and Last Name *

Primary Facility Contact Email Address *

Primary Facility Contact Phone Number *

Comments

Fields marked with an asterisk (*) are required.