Customer Booking Form
Fill in your details so we can arrange your appointment in our service schedule.
1
Contact Details
2
Service Details
Personal
Company
Company Name
Company SSM
Salutation
Mr
Ms
DYMM
Datin
Datin Seri
Dato'
Dato' Seri
Datuk
Datuk Seri
Dr
Puan Sri
Tan Sri
Toh Puan
Tun
YAM
YAB
YB
YM
Name
Email
Contact Number
+6
Model
TRITON
XPANDER
OUTLANDER
ASX
LANCER
PAJERO
ATTRAGE
COLT
GRANDIS
MIRAGE
Car Registration Number
Mileage
KM
Service Type
Warranty / Recall
Service - 1K
Minor Service - 10K, 30K, 50K
Major Service - 40K, 80K, 120K
General Repair
Checking / Diagnose
Additional Request
Add
Appointment
Branch
EAM AMPANG
EAM GLENMARIE
EAM JOHOR BAHRU
EAM BAYAN LEPAS
EAM MELAKA
EAM KUCHING
EAM KOTA KINABALU
EAM TAWAU
EAM PUTATAN
Date
Drop Key
Time
Please choose a date to check for slot availability.
I hereby acknowledge and confirm receipt of the
PDPA
Notice and consent of processing my personal data in accordance with said Notice.
Previous
SUBMIT
Loading..
Next
