Online Reservation Form
 

For immediate service within 48 hrs, please, call us at 1-212-619-5555 or 1-888-588-5088.

This is a secure Web form and all information you submit is encrypted and may not be viewed
by third-parties while in transit.

First Name*
Middle Initial
Last Name*
Organization
Mobile Phone*
Secondary Phone
Email*
Pick - Up Date*         
Pick - Up Time*      
Vehicle Type*
Event Planning*
How many hours?*
 
Delay Pickup
Not Applicable
Airport*
  if other
Not Applicable
Airline*
Not Applicable
Flight Number*
Not Applicable
Pick - Up Address*
Not Applicable
Destination Address*
Not Applicable
 
Number of passengers*
Number of luggage*
Baby Seat
Champagne
Dozen Red Roses
How did you hear about us?

Additonal Information,Return Trip Information,Reference Number, Numer of Hours, or Comments

Payment Details. (Credit Card is Required to Hold a Reservation Only)
How will You Pay*
Name on Credit Card*
Card Type*
Credit Card Number*
Expiration Month*
Expiration Year*
CCV*
3-digit code for Master/Visa/Discover
4-digit code for AMEX
Digital Signature*    Please provide your 2 initials

By submitting this form you agree that
(1) you are the credit card holder and
(2) that you are requesting the services listed above.
Please note, that credit card info needed for holding a reservation only. A %30 of the fare will be placed on hold on the card 48 hrs prior to your reservation time if you choose "Cash" payment option,and it will be released once you pay cash. A %100 of the fare will be placed on hold if you choose "Credit Card" payment option.
You will receive confirmation of your reservation through the e-mail address provided within 24 hrs.

 

* Indicates mandatory fields

(c) 2016 AAA Zoom Limousine   Contract   Credit Card Authorization Form