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Jaguar Land Rover Charging Equipment Form

Fill in the form below to request an installation quote from JET Charge for dealership customers.

"*" indicates required fields

Dealer Name*

Dealer Order/Reference Number

Contact Name*

Phone*

Email*

Name*

First Last

Unit Number

Street Number*

Street Name*

Suburb*

State*

Postcode*

Phone*

Email*

Additional Comments

Apartment Installation*

Jaguar Land Rover Model*

Estimated distance switchboard to garage / car port?*

Estimated Vehicle Delivery Date

Preferred Installation Date*

Please allow at least 10 business days to book the installation

Preferred Installation Time Slot*

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