Membership Registration Form
Complete your details, choose your package, and submit to request membership confirmation for Central Trinidad customers.
Customer Information
Full Name
*
First Name
Last Name
Mobile Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Contact Method
Phone
Email
WhatsApp
Address / Community
*
How did you hear about Alpha Auto Care?
Friend/Family Referral
Social Media
Search Engine
Walk-in/Drive-by
Existing Customer
Other
Referral Name
Vehicle Information
Vehicle Make and Model
*
Vehicle Type
*
Please Select
Sedan
SUV
Truck
Van
Coupe
Wagon
Hatchback
Convertible
Other
Vehicle Registration / License Plate
*
Number of Vehicles Being Enrolled
*
Add-Ons and Scheduling
Add-on interests
Rug extraction & detailing (from TTD $80)
Sofa extraction & detailing (from TTD $120)
Other
Price note
Preferred service days/times
Priority booking
*
Yes
No
Membership start date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Payment and Consent
Payment Method Preference
*
Credit/Debit Card
Bank Transfer
Cash
Other
Agreement to Membership Terms
*
I agree to the membership terms and conditions.
Consent to Be Contacted About Membership and Promotions
*
I agree to receive membership updates, service reminders, and promotional messages.
Comments / Special Requests
Submit Membership Application
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