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FIRST NAME
LAST NAME:
EMAIL ADDRESS *
DAY TIME PHONE:
CELL NUMBER:
CONTACT ME VIA:
CORPORATE ACCOUNT (IF ANY): *

RESERVATION INFORMATION

DATE OF BOOKING *
PICK UP TIME * RESERVATION DURATION (HRS): *
TOTAL NUMBER OF PASSENGERS *
PICK-UP LOCATION / FLIGHT *
CITY / TERMINAL *
DROP-OFF LOCATION *
EVENT *
VEHICLE *
CHILD SEAT *
SPECIAL REQUEST *
SPECIAL INSTRUCTIONS *

CREDIT CARD INFO

Card Number

Exp. Month :
Exp. Year:
CVC :

BILLING ADDRESS & TEL Billing Name :
Billing ADDRESS :
State :

Zip :

Phone :

Email :

How did you hear about us?
: I authorize Michaleslimo.com to charge the above credit card to fully reserve my event/car for the date chosen after I receive a confirmation email.