| If you are arriving within the 48 hours
please call us toll free at 1-866-884-4567 and make your reservation with one
of our customer service specialist. |
Please Fill in this Form
*
are required fields |
Fax : (407) 812 -7068 |
| CONTACT INFORMATION
|
| First & Last Name * |
|
| Street Address
|
|
| City |
|
| State |
|
| Country |
|
| Postal Code / Zip Code
|
|
| Phone (Day)
|
|
| Phone (Mobile)
|
Phone # at the time of the pickup
Please don't list hotel's number |
| Email * |
|
| Date of Arrival
|
|
| Arriving Airport
|
|
| Airline |
|
| Flight Number |
Time of Arrival
|
| City of Origin
|
|
| Total Number in Party
|
|
| Type of Vehicle * |
|
| Drop-off Location / Hotel Name
|
|
| Address & Phone
|
|
| RETURN INFORMATION
|
| Date of Trip
|
|
| Pickup Location or Address
|
|
| Drop-off Location
|
|
| Flight Departure Time
|
|
| Time of Pickup
|
|
| Type of Vehicle * |
|
| |
|
How did you hear
about us?
|
|
| I, hereby authorize Elegance Luxury Transportation 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. Driver
will take an imprint of the card and a signature at the time of the pickup and
charge the card then.
|
|
This information is being taken for the
confirmation/cancelation reasons. 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 Until the day of
your service.
|
| Print This out
and Fax it to Us at (407) 812 -7068
OR
|
|
Please click on PREPAY if you want to use our Online Fax Form.
|
