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*
Mobile Phone*
Secondary Phone
Pick - Up Date*         
Pick - Up Time*      
Vehicle Type*
Event Planning*
How many hours?*
Delay Pickup
Not Applicable
  if other
Not Applicable
Not Applicable
Flight Number*
Not Applicable
Pick - Up Address*
Not Applicable
Destination Address*
Not Applicable
Number of passengers*
Number of luggage*
Baby Seat
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*
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) 2018 AAA Zoom Limousine   Contract   Credit Card Authorization Form