Limousine, Sedan or Van Reservation Application
Use this form to submit a reservation for limousine, sedan or van service(s). Please fill it out the best you can. We will call you to go over the
details if necessary, so please be sure to include your daytime phone number.
required field
Contact Person
Company Name
Customer Name(s)
Billing Address
City
Billing State & Zip Code
,
Daytime Phone
**Please include A/C
Evening Phone
**
E-Mail: User@Domain.Com
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to block Internet email. If you have Internet email blocked, you will need to update your AOL Mail Controls. To make this update, enter the AOL Keyword 'Mail Controls' on AOL.
Date of Service
Number of Passengers
Event type
Time of Service:
Dinner, Prom etc. is not considered Split Service. Split service is like 2 hours in the afternoon and then a transfer late in the evening (Ie. a
Wedding destination transfer). This form accommodates two service intervals if you wish to do a "split" service.
Pickup time (start of service)
12 Am(Midnight)
1 Am
2 Am
3 Am
4 Am
5 Am
6 Am
7 Am
8 Am
9 Am
10 Am
11 Am
12 Pm(Noon)
1 Pm
2 Pm
3 Pm
4 Pm
5 Pm
6 Pm
7 Pm
8 Pm
9 Pm
10 Pm
11 Pm
00
05
10
15
20
25
30
35
40
45
50
55
Drop off time
12 Am(Midnight)
1 Am
2 Am
3 Am
4 Am
5 Am
6 Am
7 Am
8 Am
9 Am
10 Am
11 Am
12 Pm(Noon)
1 Pm
2 Pm
3 Pm
4 Pm
5 Pm
6 Pm
7 Pm
8 Pm
9 Pm
10 Pm
11 Pm
00
05
10
15
20
25
30
35
40
45
50
55
2nd Pickup time:
N/A
12 Am(Midnight)
1 Am
2 Am
3 Am
4 Am
5 Am
6 Am
7 Am
8 Am
9 Am
10 Am
11 Am
12 Pm(Noon)
1 Pm
2 Pm
3 Pm
4 Pm
5 Pm
6 Pm
7 Pm
8 Pm
9 Pm
10 Pm
11 Pm
N/A
00
05
10
15
20
25
30
35
40
45
50
55
2nd Drop off time:
N/A
12 Am(Midnight)
1 Am
2 Am
3 Am
4 Am
5 Am
6 Am
7 Am
8 Am
9 Am
10 Am
11 Am
12 Pm(Noon)
1 Pm
2 Pm
3 Pm
4 Pm
5 Pm
6 Pm
7 Pm
8 Pm
9 Pm
10 Pm
11 Pm
N/A
00
05
10
15
20
25
30
35
40
45
50
55
Pickup Location:
Pickup Address or Airport
Airline
Flight #
Airport Pickup location
[ Commercial Roadway ] [ Baggage
Claim ] [ Meet & Greet @ Gate ]
Scheduled Flight Arrival Time
12 Am(Midnight)
1 Am
2 Am
3 Am
4 Am
5 Am
6 Am
7 Am
8 Am
9 Am
10 Am
11 Am
12 Pm(Noon)
1 Pm
2 Pm
3 Pm
4 Pm
5 Pm
6 Pm
7 Pm
8 Pm
9 Pm
10 Pm
11 Pm
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Flight Origination City
Pickup City
Pickup State & Zip Code
,
Nearest Cross Street
Phone # @ Point of Pickup
**Please include A/C
Helpful Hints for the driver ie: Our house is the one with NO numbers and white shutters. We live abc apartment complex. Use the
2nd driveway. 2nd Building on the right.
Destination:
Destination or (As Directed / To Be Announced)
Destination Address or Airport
Destination City
Destination Zip Code
Nearest Cross Street
Destination Phone #
Select a Limousine, Sedan, Van or Specialty Vehicle.
[ 6-Pass Stretch ] [ 8-Pass Stretch ] [ 10-Pass
Stretch ] [ 12-Pass Stretch] [ 14-Pass Stretch]
[ Mini-Bus] [ Motorcoach(Bus)]
[ Stretch Excursion] [ Stretch
Explorer/Navigator] [ Stretch Hummer] [ Rolls Royce Sedan] [ Rolls
Royce Stretch]
Options....
Beverage Ice: We Require Ice No
Ice Needed
Surprise? NO YES
Payment Information
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and start over.
If not just fill in the form and it will go secure BEFORE any data is transferred!
Name as it appears on Credit Card:
Credit Card Type:
American Express
Discover
Visa
Master Card
Corporate Billed
Credit Card Numbers:
Credit Card Expiration Date mm/yy:
Please Charge my card for: A Deposit Estimated
rental charges
Add a 0%(Tip Chauffeur) 10%
15% 20% Gratuity for the Chauffeur. Most tipping guides suggest 15-20%.
Additional Needs:
Have a quick question before you submit your reservation.
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