Campaign Form | Nissan Malaysia

CAMPAIGN FORM

Personal Details

Please fill in your details accordingly. (*) denoted mandatory field.

Full Name *

New IC No *

Gender *
MaleFemale

Mobile No*

Email *

Test Drive Showroom (State) *

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Showroom*

Test Drive Model *

Test Drive Date *

SA Name *

By submitting this form, I agree to all the Terms and Conditions to receive the reward.

I hereby acknowledge and confirm receipt of the PDPA Notice and consent of processing my personal data in accordance with said notice.

Yes, I agree for ETCM to disclose, share and process my personal data with your group of companies and business partners for the purposes of promoting their products and services.