Book a Car Servicean Appointmenta Car Repaira Car Diagnostic

Complete the form below and ensure all the information is correct in order for us to assist you in completing the service request.

Your Workshop is: Jacobs – B&R Auto
Personal Details
Name (*required)

Surname (*required)

Contact number   (*required)

Your Email Address   (*required)

Vehicle Details
Vehicle Make (Manufacturer)   (*required)

Vehicle Model    (*required)

Engine Capacity (   

Vehicle Colour   (*required)

Vehicle Registration Number   (*required)

Vehicle KM Reading

Proposed Date you are bringing the car in

We will confirm via email once accepted
What service would you like done to your vehicle?
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