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1 Location

Choose a Location:

2 Contact

How would you like to be contacted?

3 Personal Information

We will need to contact you about your appointment:




Phone Number

4 Type of Repair

What glass is in need of repair?

5 Vehicle Information

What do you drive?

6 Type of Side Glass

7 Rain Sensor

If your windshield wipers turn on automatically when it rains you have a rain sensor option and should select "yes".

Rain Sensor

8 Lane Departure/Forward Collision Warning

Select “yes” if your car has a mechanism that detects when the car is moving outside of its respective lane (before the turning signal is turned on) in order to prevent collisions.

Lane Departure/Forward Collision Warning

9 Heated

If your windshield is heated throughout or has a heated wiper park area please select "yes".

Heated

10 Enter To Win the VIP Experience at Talladega

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I want to be entered into the contest, I am over 21, I have a valid passport & I agree to the offical rules.

11 Any other features or comments:

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