PDF / Word Doc.

We'd like to get to know you better.

Associated Motorways Private Limited(AMW) would like to bring you the best of automotive products with the highest standards of Customer Service. In order for us to better understand your needs and expectations; please take a few minutes to fill in the following questionnaire and return same to us directly or any of our branches.

Inquiry about:  NISSAN SUZUKI MARUTI YAMAHA PIAGGIO NEW HOLLAND OTHER PRODUCT

Salutation:  Mr. Mrs. Ms. Dr. Prof. Ven. Rev. Other

First Name *

Other Name

Surname *

Name With Initials *

NIC Number *

Date of Birth *


Postal address of residence

House No

Street

City *

District

Province:  WP CP SP NP EP UP NCP NWP SBP

Contact Details

Mobile No *

Email *


Education :  Secondary Graduate Post Graduate Professional

Household Income (LKR, in thousands)

 15-30K 30-50K 50-75K 75-100K 100-200K

Does he / she drive :  YES NO

Date of anniversary

Marital Status :  Married Single

Spouse's Name


Names of Children and their Date of Birth

Names

Dates of Birth

a]

a]

b]

b]

c]

c]


Preferred Language of Communication :  Sinhala Tamil English

Occupation / Profession

Employer / Company

Position within the company :  Owner Director C-Level Senior Middle Executive Officer Clerical

Is the vehicle owned or company provided ?  Own Leased Rented Company


Current Vehicle

Registration No

Make

Model

Mileage

Where do you service your vehicle ?

Where do you repair your vehicle ?

Year of Manufacture

Year of First Registration

 Brand New Reconditioned


Preferred Media

TV:

Magazines

Press Media:

Others

Radio

Preferred Media Type

 TV Radio Press Magazines Others


Thank you for your time. All information provided shall be treated with strict confidence and shall be used solely for the purpose of gearing AMW's service standards to better suit our customers' requirements as well as for marketing and promotional activities carried out by AMW.



NIC *

Loyalty Number *

We'd like to get to know you better.

Inquiry about:  NISSAN SUZUKI MARUTI YAMAHA PIAGGIO NEW HOLLAND OTHER PRODUCT

Salutation:  Mr. Mrs. Ms. Dr. Prof. Ven. Rev. Other

First Name *

Other Name

Surname *

Name With Initials *

NIC Number *

Date of Birth *


Postal address of residence

House No

Street

City *

District

Province:  WP CP SP NP EP UP NCP NWP SBP

Contact Details

Mobile No *

Email *


Education :  Secondary Graduate Post Graduate Professional

Household Income (LKR, in thousands)

 15-30K 30-50K 50-75K 75-100K 100-200K

Does he / she drive :  YES NO

Date of anniversary

Marital Status :  Married Single

Spouse's Name


Names of Children and their Date of Birth

Names

Dates of Birth

a]

a]

b]

b]

c]

c]


Preferred Language of Communication :  Sinhala Tamil English

Occupation / Profession

Employer / Company

Position within the company :  Owner Director C-Level Senior Middle Executive Officer Clerical

Is the vehicle owned or company provided ?  Own Leased Rented Company


Current Vehicle

Registration No

Make

Model

Mileage

Where do you service your vehicle ?

Where do you repair your vehicle ?

Year of Manufacture

Year of First Registration

 Brand New Reconditioned


Preferred Media

TV:

Magazines

Press Media:

Others

Radio

Preferred Media Type

 TV Radio Press Magazines Others






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