LookupData
Ford Ranger (XL, XLS, XLT, FX4)- (with $1,500 bond)
Ford Ranger 2016 - 2019
Kia Sportage - (with $1,000 bond)
Kia Sportage 2018 - 2020
Kia Cerato (S, Sports+, GT) - (with $1,000 bond)
Kia Cerato 2019 - 2022
Mazda CX5 - (with $1,000 bond)
Mazda CX5 2015 - 2020
Ford Everest (Sports) - (with $2,000 bond)
Ford Everest 2019 - 2022
Kia Sorento Sports - (with $1,500 bond)
Kia Sorento 2017 - 2018
Ideal Car (Manual or Automatic)
*
Please Select
Automatic
Manual
Long term or Short term Subscription
*
Very Short - 2 weeks to 4 weeks
Short - 4 weeks to 12 weeks
Long - 12 weeks - 52+ weeks
You Ideal Car Collection Time
Your ideal collection time. We will confirm this time slot with you.
What date and time work best for you?
*
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Name
*
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Date of Birth
/
Day
/
Month
Year
Date
Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Licence Details
Type of Licence (Australian or International)
*
Australian
New Zealand
International
Drivers License Number
*
State of Licence
Please Select
QLD
NSW
VIC
SA
WA
TAS
NT
ACT
OTHER
Licence Type
Please Select
L Learner licence
P restricted licence
P1 provisional
P2 provisional
O Open licence
Other
Licence Image Front
*
Browse Files
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Choose a file
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of
Licence Image Back
*
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Choose a file
Showing address
Cancel
of
Emergency Contact Person
Emergency Contact Name
*
First Name
Last Name
Emergency Mobile
*
Please enter a valid phone number.
Format: (000) 000-0000.
Ideal Date to Collect a Car
*
/
Day
/
Month
Year
Select the ideal date for collection. Cannot collect on a Saturday.
Hour Minutes
AM
PM
AM/PM Option
Affordability & Driver Declaration
CrazyCar approval process includes an affordability assessment. This does not affect your credit rating.
Work Name
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Web Address
Your Facebook URL
Copy and Paste your facebook url to help improve future communication as required.
Recent Payslip (1 month)
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Choose a file
Cannot be older than 4 weeks. If self employed a paid invoice.
Cancel
of
Recent Bank statement (1 Month)
Browse Files
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Choose a file
Cannot be older than 4 weeks.
Cancel
of
Date
/
Day
/
Month
Year
Date
Items we require on check out (Please confirm)
Minimum 4 week term with a 4 week notice on return.
Return the car clean.
Upfront Fee (Bond) paid on collection in cash ($1,000 - $1,500) depending on the car type.
Upfront Subscription (Rent) paid on collection in cash.
I understand that if I cancel or move the car booking the booking deposit may be forfeited at the disgression of Crazy Cars.
Signature
Car Booking
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Booking Subscription
Car booking
$
100.00
AUD
Quantity
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100
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Total Due
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