Reservations

Primary Information:

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*Pick-up Date

*Pick-up Time:
AM PM

*Passenger Name:

*Your Name:

*Your Phone:

*Email address for trip confirmation:

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Vehicle & Service Type:

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*Type of vehicle:

*Number of passengers:

*Type of service requested:

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Pick-up From

*Pick-up address or airport:

Pick-up phone number:

Airport Pick-up Information

Airport pick-up:

Airline:

Flight Number or Tail Number if private plane

Originating City or Airport:

Meet driver at: Baggage carousel for flight Ground Transportation - Limo Area

Drop-Off Address:

*Drop-Off Address or airport:

Drop-off phone number:

Return Pick-up Info:
(If needed)

Return Pick-up date:

Return Pick-up Time: AM PM

Pick-up address:
(If not being picked up at the airport).

Airport Pick-up Information

Airport Pick-up:

Airline:

Flight Number or Tail Number if private plane

Originating City or Airport:

Meet driver at: Baggage carousel for flight Ground Transportation - Limo Area

Special Instructions:

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Comments/Extra Stops/Special Requests:

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Payment Information:

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*Credit Card Number:

*Expiration Date:

*Security Code 3 digit (4 digits for AMEX) code on the back of your credit card

*Name as appears on credit card:

The credit card must be presented at time of service. If you want to prepay a trip we require
that you print and fax back our credit card authorization form prior to when the trip takes place.

* Denotes a required field

Privacy Notice
The information collected on this form is used by us to provide you with the requested service.
We do not share or sell this information with others.

I have read and understand Premier’s Terms and Conditions.