Lapeer Order Form

Orderform

We are here to help, Your Lapeer Store Manager is Matt Strandberg

No Credit Check - No Deposit - Free Delivery and Installation - Full Parts and Labor Warranty

Contact and Delivery Information

First Name

Last Name

E-mail:

Date of Birth

Mobile Phone #

Home Address

Apt #

City

State

Zip Code

Residency Information

Residency

Length of Time at Address

Address Match License

Monthly Payment

Landlord or Contact Person

Phone Number

Income Information

Employer or Source if Income

Employers Phone

How Long There?

Personal References

Name

Phone

Relationship

Name

Phone

Relationship

Name

Phone

Relationship

Product Interested In

By providing your information, you authorize Continental Rental to verify its accuracy. You also consent to receiving calls and text messages related to your account, which may be delivered by either a person or an automated system. These messages may include important account updates such as due dates, transaction details, or service information.

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