: :LHSA : : Advertising

Request Form

Authorized Leica repair facilities may request a free listing on the Leica Resources > Repair Sources page. References are required and your request will be reviewed before posting is granted. Complete this request form to request a free listing on the LHSA Web site.

All fields marked by a asterisk(*) are required.

I would like to be listed on the LHSA Web site’s Repair Sources page – FREE OF CHARGE.
Name *
Company *
Address *
City*
State*
Postal Code*
Phone *
Fax
URL
E-mail *
In order for us to process this request, please provide the name and a method of contacting this reference:
Reference/Customer Name: *
Reference/Customer E-mail:
Reference/Customer Phone:

Reference/Customer Name: *
Reference/Customer E-mail:
Reference/Customer Phone:

Reference/Customer Name: *
Reference/Customer E-mail:
Reference/Customer Phone: