Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you already have a van in your possession? *

Yes

No

If so, what model van do you have? *

Mercedes Sprinter 144 cargo

Mercedes sprinter 144 crew

Mercedes Sprinter 170 cargo

Mercedes Sprinter 170 crew

I don’t have one

Is your van a high roof or low roof? *

High Roof

Low Roof

If your van a 4 wheel drive or 2 wheel drive? *

2x4

4x4

What kind of conversion are you interested in?

SEMI-CUSTOM

FULL-CUSTOM

If semi-custom, what floor plan?

HAVEN- 144

BLISS - 144

SOLACE -170

INTERSTELLAR- 170

How many additional DOT approved seats do you need in your van? (not including driver and passenger) *

0

1

2

3

4+

Do you need any windows in your van? *

Yes

No

Which window options would you like to utilize? *

AM auto half slider window driver side

AM auto half slider window passenger side

CRL T-vent window driver side

CRL T-vent window passenger side

CRL 10x33 bunk window driver side

CRL 10x33 bunk window passenger side

How many people need to be able to sleep in your van? *

None

1

2

3

4

5+

What kind of bed would you like to integrate with your van? *

Fixed Panel Bed

Dinette Bed

Murphy Bed

Adventure Wagon MOAB Bed

None

Do you require a water system for your build?

Fresh Water Only

Fresh Water and Grey Water

None

Would you like hot water and heating capabilities?

Hot Water and Heating

Heating Only

None

What kind of shower do you need for your van? *

Indoor

Outdoor

Both

None

What are some necessary appliances that you need in your van?

Mark All That Apply

Air conditioning

Microwave

Induction Cooktop

Refrigerator/Freezer

Porta-potti

Other

What size power system do you require? *

200 AMP Hour

400 AMP Hour

600 AMP Hour +

I don't know, please help!

Would you like solar charging capabilities?

Yes

No

Would you like alternator charging capabilities?

Yes, Factory Alternator with 30 AMP Limit

Yes, Dual Alternator Kit

No

Does your van build require cabinetry?

Mark all that apply

Overhead Cabinets

Driver Side Galley Cabinet

Passenger Side Galley Cabinet

None

Other

Would you like any of the following exterior upgrades?

Mark all that apply

Roof Rack

Ladder

Side Steps

Bumpers

Load Lighting

Driving Lights

Winch

Storage Boxes

Other

What is your budget for your build? *

$45K - $65K

$65K - $100K

$100K - $150K

$150K +