Customer Booking Request 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
Arena 1.5 M/T
Ertiga 1.5 A/T
Ertiga 1.5 M/T
Exora 1.6 A/T
Exora 1.6 CVT
Exora 1.6 M/T
GEN.2 1.3 A/T
GEN.2 1.3 M/T
GEN.2 1.6 A/T
GEN.2 1.6 M/T
Inspira 1.8 CVT
Inspira 1.8 M/T
Inspira 2.0 CVT
Iriz 1.3 CVT
Iriz 1.3 M/T
Iriz 1.6 CVT
Iriz 1.6 M/T
Iswara 1.5 M/T
Juara 1.1 A/T
New Perdana 2.0 A/T
New Perdana 2.4 A/T
New Persona 1.6 CVT
New Persona 1.6 M/T
New Saga 1.3 CVT
New Saga 1.3 M/T
Perdana S4 2.0 A/T
Perdana S4 2.0 M/T
Perdana V6 2.0 A/T
Persona 1.6 A/T
Persona 1.6 M/T
Preve 1.6 CVT
Preve 1.6 M/T
Putra 1.8 A/T
Putra 1.8 M/T
Saga 1.3 A/T
Saga 1.3 CVT
Saga 1.3 M/T
Saga 1.6 A/T
Saga 1.6 CVT
Saga 1.6 M/T
Saga Facelift 2019 1.3 CVT
Saga Facelift 2019 1.3 M/T
Saga Magma 1.3 M/T
Saga Megavalve 1.3 A/T
Saga Megavalve 1.3 M/T
Satria 1.3 M/T
Satria 1.5 A/T
Satria 1.5 M/T
Satria 1.6 A/T
Satria 1.6 M/T
Satria 1.8 M/T
Satria Neo 1.3 A/T
Satria Neo 1.3 M/T
Satria Neo 1.6 A/T
Satria Neo 1.6 M/T
Savvy 1.2 A/T
Savvy 1.2 M/T
Suprima 1.6 CVT
Tiara 1.1 M/T
Tiara 1.5 M/T
Waja 1.6 A/T
Waja 1.6 M/T
Waja 1.8 A/T
Waja 2.0 A/T
Wira 1.3 M/T
Wira 1.5 A/T
Wira 1.5 M/T
Wira 1.6 A/T
Wira 1.8 A/T
Wira 1.8 M/T
Wira 2.0 M/T
Wira AB 1.3 M/T
Wira AB 1.5 A/T
Wira AB 1.5 M/T
Wira AB 1.6 A/T
Wira AB 1.6 M/T
Wira AB 1.8 A/T
Wira AB 1.8 M/T
X50 1.5 A/T
X70 1.8 A/T
X70 CKD 1.8 A/T
X70 1.5
X90 1.5 A/T
S70 1.5 A/T
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
Car Registration Number
Mileage
KM
Service Type
N95 Cabin Filter Replacement
General Repair
1,000 KM Free Service
10,000 KM Free Service
20,000 KM Free Service
PROCARE 30,000 KM Service
PROCARE 40,000 KM Service
PROCARE 50,000 KM Service
PROCARE 60,000 KM Service
PROCARE 70,000 KM Service
PROCARE 80,000 KM Service
PROCARE 90,000 KM Service
PROCARE 100,000 KM Service
PROCARE 110,000 KM Service
PROCARE 120,000 KM Service
PROCARE 130,000 KM Service
PROCARE 140,000 KM Service
PROCARE 150,000 KM Service
PROCARE Every 5,000 KM Service
Pre-Delivery Inspection
X50 BCM Software Update
Additional Request
Add
Appointment
Branch
Glenmarie
EON Damansara
Alor Setar
Makloom
Juru
Taiping
Larkin
Batu Pahat
Kota Bharu
Banting
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.
I agree for Edaran Otomobil Nasional Berhad and Proton Group of Companies to disclose, share and process my personal data with your group of companies and business partners for the purpose of promoting the products and services.
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