ACE ApplianceGard Enrollment Form
 
Plan (please check one)

Annual Price
A. Refrigerator, Range, and Dishwasher $195.00
B. Refrigerator, Range, Dishwasher, Microwave, and Water Heater $225.00
C. Refrigerator, Range, Dishwasher, Clothes Washer and Clothes Dryer $265.00
D. Refrigerator, Range, Dishwasher, Microwave, Washer, Dryer, and  Water Heater $295.00

Only fill out the boxes that are relevant to the plan you selected above.

Refrigerator
Manufacturer Model #
Serial #  Products Age
Range
Manufacturer Model #
Serial #  Products Age
Dishwasher
Manufacturer Model #
Serial #  Products Age
Microwave
Manufacturer Model #
Serial #  Products Age
Clothes Washer
Manufacturer Model #
Serial #  Products Age
Clothes Dryer
Manufacturer Model #
Serial #  Products Age
Water Heater
Manufacturer Model #
Serial #  Products Age
Contact Information:
Name
Street Address 
Daytime Phone
Evening Phone
Installation/Technician
Name
Employee Number
Retailers/Repair Company Name
Office Phone Number
Payment Method
MASTERCARD VISA DISCOVER
Account Number
Exp. Date
 

Disclaimer: Protection starts 30 days from the day enrollment is received.  I certify that I own the single-family home at this address and that my appliances are in working order.  I understand that once enrolled, I will be eligible for the services outlined in the service contract.  I authorize ACE Plus ESC, LLC. to bill my Credit Card

Some exclusions may apply. See your service contract for details. This program is administered by Federal Warranty Service Corporation (In FL, Voyager Service Warranties Inc.). For further clarification concerning any legal restrictions to this offer, please contact our customer service office toll free at 1-866-675-35436.

A wholly owned subsidiary of A-1 Home Services, Inc.