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Auto Collision Work Request

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First Name:
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Last Name:
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Address
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City
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State
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Zip Code
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Phone Number
Employer
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Email Address
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Make and Model of Vehicle
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Odometer Reading
Vehicle Mileage
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Please check the work to be done
Comments
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LTC Auto Collision staff and students are not able to perform recommended or required calibrations of advanced safety and driver systems. During the course of repairs, some of these systems may be disconnected and reconnected, removed and reinstalled for repairs, or replaced due to damage.  These systems must be calibrated by certified repair technicians using equipment and procedures specified by the vehicle maker. Some of these systems include, but are not limited to, lane-departure warning systems, forward collision prevention, adaptive cruise control, blind sight warning, parking assistance, as well as airbag and restraint systems. It is recommended and the responsibility of the owner for all vehicles to be taken to an O.E.M. certified location for post repair diagnosis and calibrations.

  • I understand that the LTC Automotive Collision Repair Shop must complete an estimate before they accept work related to my vehicle.  I further understand that estimates are by appointment only.
  • If an opportunity arises for use of my vehicle as a learning tool, I understand that I will be contacted and will need to make the requested arrangements.
  • I understand that the type of work to be done must fit the instructional intent of the Auto Collision Repair program
  • I understand that not all work requests will be fulfilled.
  • I understand that this work request will be considered when the described work is being taught in the curriculum. I verify that there is not an immediate need for completion of this project.
  • I agree to bring my vehicle to the Automotive Collision Repair Shop upon their request; and I agree that it will remain at the shop until the work is completed.
  • I agree that materials used will be supplied by the Auto Collision Repair Shop department.
  • I understand that the policy of the Lakeshore Technical College prohibits the introduction of any and all weapons, alcoholic beverages, and controlled substances upon the College campus. I understand that before bringing a motor vehicle upon the College campus for work in the Automotive Shops, I must inspect the vehicle and remove all prohibited items. I further understand that if weapons, alcoholic beverages, or controlled substances of any type are found in the motor vehicle when present on the Lakeshore Technical College campus, a report will be made to law enforcement authorities.
  • I understand that the work, described above, will be completed by the students of Lakeshore Technical College who are being trained through academic coursework to perform work of this type.
  • I further understand that the quality of the work is not guaranteed and that no warranty applies to the work.
  • I agree to report any improperly completed work to LTC’s Auto Collision Repair Department.
  • In consideration of the work being done at the reduced cost (materials/supplies only), I agree to waive any and all claims which I may have against the Lakeshore Technical College, students of the College, and members of the College faculty and administration, which are in any way related to the manner in which the work is accomplished.
  • I understand that there is no guarantee of the completion day or time.
  • I understand that I will be notified at the time when the work is completed.
  • I agree that my vehicle will not be released to me until the invoice is paid for with cash, check, MasterCard, or Visa, which can only be done during LTC business hours.
  • I understand and agree that the work is performed at my risk.
  • I agree that as a participant in this learning process, I cannot hold the students, instructor, or institution responsible for my personal safety because of my participation in this learning situation.
  • As the owner of this vehicle, I agree to the following for Additional Authorized Driver(s):  The owner hereby permits the operation of the above-described vehicle as required to assess work needed, to assess requested repair, and/or to evaluate the repair work done to ensure proper completion. The “test drive,” when deemed necessary, will be conducted by the student technician and instructor as a method of assessment and evaluation of the repair work. The length and duration of the “test drive” will be of sufficient duration only to allow for proper assessment and evaluation.
  • By submitting this request, I grant permission to the students and instructors/employees of LTC to operate the vehicle described above for testing and/or inspection purposes.
I request that work be done under the above conditions.