RESERVATION FORM

   CUSTOMER INFORMATION

 

 Company:

 Passanger Name:

*

 Phone:

 Email:

*

 

   CALLER INFORMATION

 

 Caller Name:

*

 Phone:

 Email:

*

 

   RESERVATION DATE

 

 

 IF YOUR RESERVATION IS FOR TODAY PLEASE CALL:  718-482-7667 OUTSIDE NY 800-482-4009

 Requested Date:

 Requested Time:

: :

 

  

 

 

 

 

 

 

      

   VEHICLE SELECTION

 

 

 Vehicle:

 # of Passengers:

 

 

   WHERE WOULD YOU LIKE TO BE PICKED UP?

 

 

 

  Airport   Other

  ARRIVE AIRPORT INFORMATION

 

 

 Airport:

 Airline:

 Flight #:

 Arriving From (City):

 Special Instructions:

  Curb Side   Baggage Claim

 

 

 

 

   WHERE WOULD YOU LIKE TO BE DROP OFF?

 

 

 

 Airport   Other

  DEPART AIRPORT INFORMATION

 

 

 Airport:

 Airline:

 Flight #:

 Arriving From (City):

 Special Instructions:

  Curb Side   Baggage Claim

 

 

 

   PAYMENT INFORMATION

 

 Payment Method:

       Account#:

 Credit Card #:

 Card Holder:

 Expiration:

Month: Year:

 

 

 3 digits sec. code:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CREDIT CARD CHARGES TERMS

     

 

 

 

I AGREE TO THE CREDIT CARD CHARGES *

 

 

 

 

 

 

* Required fields

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  DEPART ADDRESS INFORMATION

 

 

 Address:

 Apt / Suite:

 City:

 State:

 Zip:

 Special Instructions:

 

 

 

  ARRIVE ADDRESS INFORMATION

 

 

 Address:

 Apt / Suite:

 City:

 State:

 Zip:

 Special Instructions:

 

 

 

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38-30 31st Street, 3rd Floor - Long Island City, N.Y. 11101 - Phone (718) 482-7667 | Fax (718) 482-8163 Out Of Town 800-482-4009

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