Newark & Middletown Appointment Form

Welcome to Benchmark Transmission in Newark, DE! Streamline your service experience with our convenient online appointment form. To schedule your next visit, simply complete the form below. Please be aware that this form is specifically for appointment requests and is subject to shop scheduling availability. Thank you for choosing Benchmark Transmission, we look forward to providing top-notch service for your vehicle.

Shop & Preferences

Shop Location *

Select Location

Drop-Off / Wait Preference

Drop-Off / Wait Preference Drop Off & Pick Up Drop Off & Need Ride Pickup & Return Vehicle Wait During Vehicle Service

Contact Preference

Contact Preference Phone Call Text Message Email Message

Customer Information

First Name *

Last Name *

Website URL*

Email Address *

Telephone *

Text Message Authorization

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Preferred Appointment Times

Preferred Date ( Shop must be selected ) *

Preferred Time *

Select Time

Optional Date

Optional Time

Select Time

Vehicle Information ( License plate and/or VIN is appreciated if available. )

Year, Make & Model *

Vehicle Mileage *

License Plate

State

State AL AK AB AZ AR BC CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MB MD MA MI MN MS MO MT NU NE NV NB NH NJ NM NY NL NC ND NT NS OH OK ON OR PA PE QC RI SK SC SD TN TX UT VT VA WA WV WI WY YT

VIN - 17 Characters (Click ? for VIN Assistance)

How to find your VIN

Insurance Card:
VIN numbers can also be located on vehicle insurance cards.

Vehicle:
Usually located on the driver's side dashboard (viewable from the windshield) or inside driver's side door jamb (on a sticker).

Description & Referral Details

Service / Repair Description*

Referral Source

Select Referral Source Internet Search Engine AI - Artificial Intelligence Repeat Customer Person / Business Social Media Other

Details

Referrer Name

Company

Other Source

Select Other Source Television Radio Newspaper Yellow Pages Not Listed

Describe Other Source

Search Engine

Search Engine Google Bing AOL Yahoo Yelp Ask DuckDuckGo Not Listed

Search Phrase

AI Source

AI Source ChatGPT (OpenAI) Google Gemini Claude (Anthropic) Microsoft Copilot Meta AI (FB/IG/WhatsApp) Perplexity.ai Apple Intelligence / Siri Amazon Alexa You.com Other / Not Listed

Question Asked

Social Media

Select Media Facebook Instagram Yelp Next Door Twitter LinkedIn Pinterest YouTube Not Listed

Special Offers & News

Absolutely! Sign me Up.

Street Address

Street2 (Apartment, Unit, Etc.)

City of Residence

State / Province

Select State / Province Alabama Alaska Alberta Alaska Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick Newfoundland and Labrador New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon

Postal Code

Birthday Month

Month January February March April May June July August September October November December

Birthday Day

Day

BIRTHDAY: Please provide your birthday in the event that the shop would like to send birthday well wishes with special offers.

Submit

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