Preferred Date January February March April May June July August September October November December Day 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 31
Estimated Drop-off time Preferred Pick-up time
What make of car is it? Holden Daewoo Ford Toyota Nissan Mazda Mitsubishi Other Specify if other
What model is it? and what year is it?
Registration Number Kms
Have we serviced your car before, or did you buy it here? Yes No
Service required Coupon Book Service Unscheduled Service or Repair 'Certified Used Vehicle' warranty service
Do you require a hire car ($39.00 per day)? Yes No
Extra items needing attention
Please tell us how to get in touch with you
Name
Email
Phone
Suburb
We will contact you, usually within 24 hours, to confirm your booking. Thank you
