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Name
*
Please enter your full names
Email Address
*
Chassis Number
*
Enter the car's chassis number
Year of Manufacture
Odometer Mileage
Registration Number
Fuel type
*
Petrol
Diesel
Model
*
Select your model of Mazda
Demio
Axela
Premacy
Atenza
Verisa
MPV
CX3
CX5
CX7
CX8
CX9
RX8
323
Tribute
Biante
Etude
Capella
323
626
BT50
Bongo
Rustler
Titan
Nature of service
*
Normal Periodic Oil Change
Transmission Oil Change
Bodywork Services
Wiring Services
Suspension Services
Engine Repair
DPF Delete
Cooling system service
Climate Control
Select the kind of service(s) you want done/performed onto your car.
Summary of services in your own words
Reservation Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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29
30
31
Year
Year
2024
2025
2026
