Service Application Form - Lacanche USA

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Home > Care & Service > Service Application Form

Service Application

Application for servicers wishing to work on Lacanche ranges for Art Culinaire.

Company Legal Name*
Trade Name
Business License #
State(s)
Mailing Address*
Street Address Address Line 2 City State ZIP Code
- Shipping Address same as Mailing Address
Shipping Address
Street Address Address Line 2 City State ZIP Code
Other Address
Street Address City State ZIP Code
Main Phone*
Other Phone
Fax
Text Phone
Date the business started
How long at present location
Owner Name*
Owner Phone
Owner Email*
Owner Text Phone
Service Contact*
Service Phone*
Service Email*
Service Text Phone
Accounts Payable Contact
Accounts Payable Phone
Accounts Payable Email
Accounts Payable Text Phone
Owner preferred contact method
- Phone
- Text
- Email
Service preferred contact method
- Phone
- Text
- Email
Accounting preferred contact method
- Phone
- Text
- Email
Total Employees
Number of Service Technicians
Number of Qualified Electricians
Number of Gas Technicians
Uniformed Employees
- Yes
- No
Background Checks Done
- Yes
- No
Drug Tests Done
- Yes
- No
How Many Trucks
Are Trucks Logo/Lettered
- Yes
- No
Do You Have an Airsled
- Yes
- No
Comments
Service Information
Products Serviced
- Electric Ranges
- Gas Ranges
- Vent Hoods
Products Installed
- Electric Ranges
- Gas Ranges
- Vent Hoods
Brand Names Serviced
Brand Names For Which Your Are Certified
Primary Areas/Cities/Counties/Zip Codes Covered
Coverage Determined By
- Service Radius
- Zip Code
Area of Coverage*
- 15 mile radius
- 25 mile radius
- 50 mile radius
- Travel Outside Your Area
How Far Do You Travel Outside Your Area
Preferred Courier For Receiving Parts
- USPS
- UPS
Rates
Rate structure*
- Flat fee
- Hourly
Rate*
- Minimum trip fee
Trip Fee
- Mileage fee beyond certain distance
Mileage fee and distance

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Art Culinaire became the official US distributor of Lacanche Ranges in 1995. Since then, they have elevated the expression of culinary arts to both cooking enthusiast and chefs alike.

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