Service Booking Request
Full Name:
Select
Mr.
Mrs.
Ms.
Mdm.
Dr.
Prof.
Vehicle Number:
Vehicle Model:
Select
Captur
Clio
Clio RS
Modus
Megane
Megane GT
Megane GT-Line
Megane Sedan
Megane Hatchback
Megane CC
Megane R.S.
Fluence
Fluence Z.E.
Latitude
Scenic
Grand Scenic
Koleos
Laguna
Laguna Coupe
Kadjar
Kangoo
Kangoo WAV
Kangoo Z.E.
ZOE
Trafic
Master
Others
Contact Number:
Select
Home
Office
Mobile
Email:
Note: An email will be sent to you upon successful service request submission.
Preferred Mode of Contact:
Select
Call
Email
SMS
Service Request Type:
Select Service Type
Service Maintenance
Mechanical Repair
Body & Paint Repair
Additional Comments:
Venue
Select
Service Centre @ 28 Leng Kee Showroom
Service Advisor (Preference, if any)
Select
Dennis Ngan @ 28 Leng Kee Rd
Ivan Ku @ 28 Leng Kee Road
Peh Eng Hwee @ 28 Leng Kee Rd
Rashid Bin Othman @ 28 Leng Kee Rd
Preferred Appointment (Date/Time)
Preference 1
Date
<
September 2023
>
Sun
Mon
Tue
Wed
Thu
Fri
Sat
27
28
29
30
31
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
1
2
3
4
5
6
7
Time
08
09
10
11
12
13
14
15
16
17
:
00
15
30
45
Preference 2
Date
<
September 2023
>
Sun
Mon
Tue
Wed
Thu
Fri
Sat
27
28
29
30
31
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
1
2
3
4
5
6
7
Time
08
09
10
11
12
13
14
15
16
17
:
00
15
30
45
Additional Arrangements:
Taxi Booking (charges apply)
Pick-Up / Delivery Service (charges applies)