document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub9.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=707927773&formid=4065&formpadding=0\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:707927773:9:4065\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div>Request A Service</div></div> <div class=\"bn-form-desc\"><p>Request a service from us by filling out the form below.</p></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Name: <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-1\" placeholder=\"\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Email: <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-2\" placeholder=\"\" validator=\"email\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Phone #: <span class=\"bn-required\">*</span></span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-168978775531260\" placeholder=\"\" validator=\"\" required=\"required\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Boat Brand: </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-168978785154079\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Year: </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-168978786258699\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Engine Brand: </span> <span class=\"bn-input\"><input type=\"text\" name=\"Field-168978787515992\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Service Requested: </span> <span class=\"bn-input\"><textarea name=\"Field-3\" placeholder=\"\" validator=\"\"></textarea></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Upload Photos &gt; </span> <span class=\"bn-input\"><input type=\"file\" name=\"userfile\" value=\"\"> <input type=\"hidden\" name=\"MAX_FILE_SIZE\" value=\"2097152\"></span></div></div>  <input type=\"hidden\" name=\"carboncopy\" value=\"\"> <input type=\"hidden\" name=\"thankyou\" value=\"https://parksvilleboathouse.com/request-service/confirmation\"> <input type=\"hidden\" name=\"thankyoutext\" value=\"\"> <input type=\"hidden\" name=\"subject\" value=\"Request A Service Form Submission\"><div class=\"bn-form-submit\"><button type=\"submit\" class=\"formbtn\">Submit</button></div> <style type=\"text/css\">.bnet-form ::-webkit-input-placeholder {');
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