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© Copyright 2011 Your Business Name . All rights reserved.
Terms
|
Credit Authorization Form
By
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Contact Information
Full Name:
*
Phone Number:
*
Email:
*
Email (Confirm):
*
Transportation Service Information
Type of Service:
*
Click to Select
Airport
Corporate
Tour Package
Hourly
Charter
Wine Tour
Leisure
Please Select Your Vehicle Type:
*
Click to Select
Luxury Sedan
6 Passenger Limousine
8 Passenger Limousine
10 Passenger Limousine
12 Passenger Limousine
12 Passenger SUV Limousine
14 Passenger SUV Limousine
16 Passenger SUV Limousine
18 Passenger SUV Limousine
20 Passenger SUV Limousine
22 Passenger SUV Limousine
24 Passenger Charter Bus
36 Passenger Limo Bus
40+ Passenger Coach (Bus)
Total Hours:
*
Pick Up Info
Address:
*
City:
*
State:
*
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California
Nevada
Number Of Passengers:
*
Date:
*
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Destination
Address:
*
City:
*
State:
*
---
California
Nevada
Date:
*
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Time:
*
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Drop-Off Instructions:
Payment Information
Credit Card:
*
Click to Select
Visa
Master Card
American Express
Discover
Credit Card #:
*
Expiration Date:
*
MM/YY
Card Security Code:
*
Name Of Cardholder:
*
Billing Address:
*
Comments:
HOWDID YOU
LEARN ABOUT
OUR WEBSITE:
Other
Yahoo
Google
MSN
AOL
Business Associate
Family / Friend
I have read and agree to the
terms and conditions
.
I understand that deposits are not refundable due to client cancellation, and authorize starzlimousine.net to process
charges to my credit card for rental service, overtime & any damages that might be incurred to the limousine by my
guests or myself. I the customer take full responsibility and hereby waive any and all claims against starzlimousine.net.
