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Job Request

This form is intended for use by NEW ZEALAND AUTO GLASS account holders only. [*] Denotes a required field.

// JOB DETAILS

// COMPANY DETAILS

Select 'Other' if your Branch is not listed

// VEHICLE DETAILS

Select 'Other' if your Make is not listed
Select 'Other' if your Year is not listed
Select 'Other' if your Body Style is not listed
Select 'Other' if your Work Required is not listed

// FRONT WINDSCREEN FEATURE(S)

Check all that apply above

// REAR WINDSCREEN FEATURE(S)

Check all that apply above

// SIDE / DOOR GLASS PART(S)

Check all that apply above

// IMAGE UPLOAD

Maximum filesize of 10 MB

// COMMENTS / INFORMATION

Did You Know?

Most damage to modern windscreens are chips from small stones that tyres throw into the air. The impact doesn't shatter the glass, but the crack weakens the glass, and will spread if you don't repair the chip.

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