TO USE THIS FORM: PRESS PRINT , fill out & fax to 03 5448 4111
IMPORTANT: Please contact BRUCE on 0428 574 067 prior to completing this form to check the availability of vehicles, hire times and dates.
Completing this form without prior contact will not confirm your choice of date, time or vehicle.
CONTACT DETAILS OF PERSON MAKING THIS BOOKING
NAME _______________________________________________________________________
POSTAL ADDRESS ____________________________________________________________
TOWN /CITY ___________________________ POSTCODE ___________________________
PHONE__________________________EMAIL_______________________________________
| CARD DETAILS : mastercard / visa / diners* / Amex* (*6% surcharge applies) | |||||||||||||||
|
EXPIRY DATE |
/ |
CCV |
*CCV is the LAST THREE digits on the back of your card in the SIGNATURE PANEL |
|
Please charge the amount of |
$ |
To the above card details , being for DEPOSIT / FULL AMOUNT (circle selection)
CARDHOLDERS NAME
________________________________________________________
CARDHOLDERS SIGNATURE_______________________ DATE_______________________
HIRE DETAILS:
Vehicle type _____________________________________________________(e.g 6 passenger stretch limousine)
Hire Date ____________Day ____________Month _______________Year
Hire Start Time _________________ am / pm
Hire start Address ___________________________________________ street____________________ town/city
Hire Duration __________Hour/s __________Minutes
FAX COMPLETED FORM TO Oz Limos FAX: 03 54 48 4 111