ONLINE CONFIRMATION

CLIENT NAME *

Please enter the name your reservation is under.
DATE OF TRAVEL * MM / DD / YYYY
Please enter your date of travel.
PHONE NUMBER * ### - ### - ####
Please enter the best phone line to reach you directly.
CONFIRMATION # *

Please enter the confirmation number located on the bottom right of your reservation.
NAME ON CC USED FOR RESERVATION *

Please enter the name as it appears on your CC.
CC NUMBER USED FOR RESERVATION *

Please enter your CC number. We accept Visa and Mastercard.
CC EXPIRATION DATE *

Please enter the expiration date on your CC.
EXAMPLE: 0214
CC SECURITY # *

Please enter the four digits as they appear on the back of your CC.
CC BILLING ADDRESS *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please enter the full billing address that your CC statement goes to including zip code.
If you agree to the terms below, please check the box. *
I understand that no verbal agreements, guarantees or warranties shall or will be honored before or after my job unless in writing on my contract. I warrant that I have seen my vehicle online and the vehicle # on my contract is the vehicle that I orderd. I understand that all sales are final and all deposits are non-refundable. I understand that if I cancle within 20 days I will be responsible for my TOTAL BALANCE DUE. I understand that if I ordered a VIP Package, only the Venue will be responsible for my VIP. I understand that the Limousine is responsible for my SAFETY only.

For questions, call 508-LIMOUSINE. (508-546-6874)
Do Not Fill This Out

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