CONTACT INFORMATION
Name*
Surname*
Phone*
Mobile*
Fax
Email*
Address
CAR INFORMATION
Chassis number
Car brand (select one)*
Plate number
Car model (name)*
Mileage (Km)
Date 1st registration
SERVICE REQUIRED*
Quick service
Revision / Inspection
Mechanical repair service
Electrical repair service
Trouble shooting
Accident repair
Additional remarks
DATE AND LOCATION
Service center
Date (option 1)
Date (option 2)
Note: Appointment date booking must be at earliest after 3 working days from the date you fill out this form.We will contact you 24 hours before to confirm the appointment.
Request of rental vehicle
YES
NO
