Road Test Request Fill out this form and we will contact you as soon as possible. *Fields marked with an asterisk are mandatory First name * Last name * Address City Province - None -AlbertaBritish ColumbiaManitobaPrince Edward IslandNew BrunswickNova ScotiaNunavutOntarioQuébecSaskatchewanNewfoundlandNorthwest TerritoriesYukon Postal code (format: A9A 9A9) Telephone * Ext. E-mail * Desired vehicle Road test date Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20132014201520162017 Questions or comments Newsletter YES! I want to receive information on future contests, surveys, special promotions and new content from Mercedes-Benz Laval. CAPTCHAThis question is designed to prevent automated spam submissions. Math question * 7 + 8 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.