Reservation Form

Print PDF

Version 1.5.14 Airport Limousine Site default language: English (United Kingdom) Preview01Logout * Site * Menus * Content * Components * Extensions * Tools * Help Preview Save Apply Close Help Article: [ Edit ] Title Published No Yes Alias Front Page No Yes Section Category

PLEASE!!! Turn your SPAM BLOCKER OFF
because you will not receive a confirmation

Your Information
Price Quoted From?
Quoted Price:
Occasion:
Name:
Email address:
Contact Cell phone number:
How Did you hear about us?
Service Information
Trip Type: One Way Round Trip
As Directed
Type of Vehicle:
Date of the Event? [12/15/03]
Pickup Time? [12:15 PM]
Number of hours needed for?
Number of passengers?
Pickup Information
Pickup Address:
Drop Off Address:
Special Instructions:
Airport Information (airport pickups only)
Airport Arriving to/from?
Airline:
Flight Origin:
Time of the Arrival:
Flight Number:
Number of Luggage:
Payment Information
Credit Card: Visa
Master Card
Discover
Card Number:
Card Holders Name:
Expiration Date [08/09]
Last 3 digits from Signature Line: VISA/Master
Billing Address:

I, hereby authorize New York Exotic Limousine to charge the above listed credit card account the amount indicated on my contract, and that I will in good faith, make good on the contracted charges.

I, the undersigned, do hereby personally guarantee payment of the full contracted amount in the event of non-payment without just cause by the above named company. This information is being taken for the confirmation/cancelation reasons.

YOUR CARD IS NOT BEING CHARGED PRIOR TO YOUR PICKUP unless we specify in confirmation email. Driver will take an imprint of the card and a signature at the time of the pickup and charge the card then.

Remember!
We DO NOT charge your credit card unless deposits for SUVs.
We authorize it ONLY.
(Autorize - means bank puts that amount on hold until the service date)
You pay to the driver directly UP FRONT.

Avoid the extra 8.25% tax by paying the driver in CASH.


 

< Prev