Michael Jordan Nissan

Thank you for choosing Michael Jordan Automotive Group. We value your time and relationship.

Please complete and submit this form. One of our experienced technicians will contact you shortly to confirm your appointment.

* indicates required fields.

Vehicle Information

Year
Make
Model

Mileage
License Plate

Body Shop Information

Type of Service Needed

Requested Appointment Date

Please select a calendar date that is best for you.

Requested Appointment Time

Do You Require
Shuttle Service Rental Car Wait In Lounge

Contact Information

First Name
Work Phone
Fax
Address
Preferred Contact
Comments

Last Name
Best Contact Number
Email Address
City
State
Zip Code