menu.gif (10840 bytes)

Reservation / Quote Form
#1 Limousine Service

For an accurate Quote, please fill out entire form

Quote Reservation

Mr. Mrs.Ms.Miss
Name:
First:

Last:
Address:
Street:
City: State: Zip:
Country:
E-Mail Address:
Phone Number:

Trip or Event Information:

Pick up Date: Day:
Pick up time:ampm # of passengers
Pick up Location:
(if you choose "Other" please specify)
Type of Car Requesting:
Sedan(up to 4 people) 6 passenger 8 passenger
10 passenger

(Fill in box with Drop off Info.:)


Please fill out this section only if airport is selected:
one way
round trip
Airline: Flight #:
ETA(estimated time of Arrival): Departing City:

Return Trip Info:
Pick up Date: Day:
Pick up time:ampm # of passengers:

Pick Location:
(if you choose "Other" please specify)

Type of Car Requesting:
Sedan(up to 4 people) 6 passenger 8 passenger
10 passenger

(Fill in box with Drop off Info. for return trip:)


Payment Information: ( Optional: you can just submit this form to get a Quote by leaving this section blank)

Payment : cash
Credit Card: Master CardVisaDiscover AmexDiners
Card #:Expiration Date:
Name on Card:

Additional Info...

 

 

#1 Limousine Service
Phone
(631) 385-7882
Fax      (631) 351-2158
e-mail