WATCH REPAIRS Form

CLOCK REPAIRS FORM
Print a copy of this form after you have filled it out
and enclose it with your Clock and Mail to:

Antique Watch & Clock World
P.O. Box 2222
Des Plaines, Il. 60018

Or Email this form to us
after filling it out and click submit.
This form is for you to email us your questions
so it gives us an idea on your inquiry
Please fill in the form below to send us details about your repairs or any questions.
We will reply to you within 24 hours with an estimate for repair.
Please make sure when you send your watch you add your
Email Address and Telephone Number, or we cannot reply

* Name
* Address City, State, Zip Code
* Telephone Number
* Type of enquiry
* Make and Model
Number on the back of your movement
Case Type
Clock last repaired/serviced?
How old is your clock

Please use this form to email us(*make sure your Email Address is filled in correctly.)

Please use the text box to describe what is wrong with the Clock or the work you require.

* E-mail address (must be completed

* Confirm Email