Servicing Request Form - Suffolk Marine Safety

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This field is for validation purposes and should be left unchanged.

Have you been a customer with us before?(Required)

If you have hired, shopped or service with us previously please select Yes as we will have your details on file.

Would you like a quotation or to place a booking?(Required)

If you choose place a booking we will go ahead and create a hire contract from the details you provide in this form. The contract once it has been created will be sent to you electronically via an email service called 'Signable'.

Your Contact Details

Mobile Number(Required)

Landline Number

Type of Lifejacket

Automatic with Harness(Required)

Enter the number of Automatic with Harness Lifejacket(s) you would like to hire

Automatic Non-Harness(Required)

Enter the number of Automatic Non-Harness Lifejacket(s) you would like to hire

Additional Information

Vessel Details

Name of Vessel

Vessel Type(Required)

Intended Sailing Area(Required)

Coding Category(Required)

Coding is required by the Maritime Coastguard Agency (MCA) for Commercial users. Leisure sailing are not coded unless racing and the race will stipulate a Coding Category.

Activity(Required)

Hire Terms & Dates

Please select the type of hire term you are interested in. If you start or end date is on a weekend, we will adjust the date to allow for lifejacket(s) to be delivered on a weekday. We do not deliver or collect on the weekend.

Hire Start Date(Required)

This is the date the hire will begin from. We will dispatch your lifejacket(s) to arrive in time for your 'Hire Start Date'. We do not deliver on the weekend or bank holidays.

Hire End Date(Required)

This will be the date the hire will end on and will be returned to us or packed ready for us to arrange collection. We do not collect on a weekend or bank holiday.

Receiving Hire Item(s)

Returning Hire Item(s)

Additional Information / Comments

Please add any other details and requirements, or questions you would like us to help with. If you would like to also make a purchase please enter the product name and any details including qty and size and we will also supply a quotation or a sales invoice, along with your hire.

Marketing Preferences

How did you hear about us?(Required)

It helps us to know how our customers find us, please select how you found out about our services.

Date Completed(Required)

Please select todays date

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