Skip to main content
BOOKING FORM
Personal Details
Salutation
*
- Select -
Mr
Mrs
Ms
Dr
Prof
Datuk
Dato’
Tan Sri
Datin
Datin Paduka
Datuk Seri
Puan Sri
Dato’ Seri
Dato’ Paduka
Datin Sri
Other
First Name
*
Last Name
*
Contact Number
*
Email Address
*
Booking Model
*
- Select -
Emeya - RM 5,000.00
Eletre - RM 6,000.00
Emira - RM 10,000.00
Booking payments are processed through Quick Queue Sdn Bhd, a third-party provider.
Payment Method
*
Credit Card via eGHL
YES, I have read and understood the
Lotus Cars Malaysia Privacy Policy
and I consent to my personal data, being processed and used by Lotus Cars Malaysia for the purposes to receive information of any campaign and event organised by Lotus Cars Malaysia.
*
Finish
X
Please enter valid mobile phone no.
X
Please enter valid fax phone no.
X
Please sign the indemnity form.
