E-form

PETRONAS Dagangan Berhad requires you to provide your personal data (i.e., fullname, phone number, identification number and email address) for the purpose of Bonanza 50 with PETRONAS Sprinta Contest. By participating in this contest and by providing your personal data, you as participant hereby agrees and provides consent to PETRONAS Lubricants Marketing (Malaysia) Sdn Bhd (PLMMSB) which is a subsidiary of PETRONAS Dagangan Berhad (PDB) to collect, process, use, disclose and keep the participant’s personal data in accordance with Personal Data Notice for Customers issued pursuant to the Personal Data Protection Act 2010 and can be found on MyMesra
Full Name (As per IC)
Identification Card Number (90XXXX-XX-XXXX)
Phone Number (010XXXXXXX)
Email Address

Where did you purchase PETRONAS Lubricants?

Workshop name

Mechanic Name

Upload receipt
Not more than 5MB

Please tick this box.

Text

#XXX

Thank You

Your entry has been submitted!
*Note: Please screenshot this page to save your filled form for your records.
If you have any questions or need assistance, feel free to reach out to us.
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Sorry

You can only submit one entry!

Resit Peraduan

Kod

AA001

Nama : 

xxx xxx xxx

No. Kad Pengenalan : 

xxxxxx-xx-xxxx

No Telefon : 

xxx-xxxxxxx

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