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Diplomat Limousine Service

To Reserve A Vehicle please fill out the Secure Reservation form Below

 

* INDICATES REQUIRED FIELDS

 

CONTACT INFORMATION / GUEST INFORMATION                                 

*FIRST NAME *LAST NAME

*PHONE        

CELL PHONE

*EMAIL         

HOW DID YOU HEAR ABOUT US?  Email Google Yahoo MSN Other Search Engine Newspaper Our Monthly Newsletter Catalog Tradeshow Friend Co-Worker Business Card Television Radio Direct Mail Newsgroup Tourist Information Magazine Other Source

TRIP INFORMATION                                                                                         

*TRIP TYPE  ROUND TRIP ONE-WAY HOURLY WEDDING HOURLY PROM HOURLY NIGHT-OUT HOURLY / AS DIRECTED

  IF HOURLY, HOW MANY HOURS? SELECT HOURS 4 Hrs (minimum) 5 Hrs 6 Hrs 7 Hrs 8 Hrs 9 Hrs 10 Hrs 11 Hrs 12 Hrs

*CAR REQUESTED SELECT VEHICLE Town Car Lincoln Stretch 6 Pax Lincoln Stretch 8 Pax Lincoln Stretch 10 Pax Cadillac Escalade ESV / SUV 10 Passenger Van With Luggage 14 Passenger Van W/O Luggage

*NUMBER OF PASSENGERS     

*NUMBER OF LUGGAGE/BAGS

PICK-UP INFORMATION                                                                                  

*PICK-UP DATE (MM/DD/YYYY)

*PICK-UP TIME (HH : MM )        *AM/PM AM/PM AM PM

AIRLINE (If Applicable)  FLIGHT / TAIL#

*PICK UP ADDRESS            

*DESTINATION ADDRESS 

RETURN TRIP INFORMATION (IF DESIRED / IF NECESSARY)              

RETURN DATE (MM/DD/YYYY)

PICK-UP TIME (HH : MM) AM/PM AM/PM AM PM

PICK-UP ADDRESS            

DESTINATION ADDRESS 

BILLING INFORMATION                                                                                 

*FORM OF PAYMENT        VISA MASTERCARD AMERICAN EXPRESS DISCOVER DINERS CLUB

*CREDIT CARD NUMBER 

*EXPIRATION DATE (MMYYYY)

*CREDIT CARD SECURITY CODE (CVV) 

*NAME OF CARD HOLDER 

*BILLING ADDRESS LINE 1 

BILLING ADDRESS LINE 2   

*CITY *STATE *5-DIGIT ZIP CODE

COMMENTS / INSTRUCTIONS (If Necessary)

Remember! We DO NOT charge your credit card Until the day of your service.

By Submitting this request you have read and agree to our terms & conditions.

Please Hit Submit Only Once Until You See the Confirmation Page!

 

 

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