Stretch Limousine, Inc.

4915 N. Cumberland Ave. Norridge, IL. 60706-4238

Phone: 773-230-1637 Fax: 708-452-2998

info@stretchlimochicago.com

 

FAX RESERVATION

 

Customer Information:

First Name: _________________________  Last Name:      ____________________________________


Street: _____________________________   City: ____________________ State: ____   Zip: _______

 

Phone Number: ______________________   Fax Number (If any): _____________________________

 

 

Service Requested Information:

 

Type of Occasion: ________________________________   Date of Service:  _____ / _____ / _______

 

Exact Time: _______________    Duration: _______________           Limo Size: ____________ Persons

 

 

Pick-Up Address:

 

Business (if applicable): ______________________________________________________________

 

Street: _____________________________   City: ____________________ State: ____   Zip: _______

 

Drop-off Address:

 

Business (if applicable): ______________________________________________________________

 

Street: _____________________________   City: ____________________ State: ____   Zip: _______

 

 

For airport service, please provide additional information:

 

Airport Name: ___ ORD-O'Hare        ___ MDW-Midway          ___ Pal waukee            

(check one)                              ___ Du Page         ___  Meigs Field                      ___Other: _______________

 

Airline: ______________________     Flight Number: __________

 

Date of Arrival/Departure: _____ / _____ / _______       Time of Arrival/Departure: _______ A.M / PM

 

 

Comments:    ________________________________________________________________________

 

 

How did you hear about Stretch Limousine? _______________________________________________

 

 

Note:       Please also fill out the credit card authorization form.  For wedding services, please fill out the additional contract form.