RESERVATION FORM
Reservation Date :
(MM/DD/YY)
Type of Vehicle :
---Select a Car---
Luxury Sedan ( 1-4 passengers )
Stretch Limousine ( 1-8 passengers )
Super Stretch Limousine ( 1-10 passengers )
Number of Passenger (s) :
Number of Vehicle (s) :
FROM / TO
Pick-up Address / Hotel Name :
Pick-up Time :
---Select a Time---
12:00
12:15
12:30
12:45
1:00
1:15
1:30
1:45
2:00
2:15
2:30
2:45
3:00
3:15
3:30
3:45
4:00
4:15
4:30
4:45
5:00
5:15
5:30
5:45
6:00
6:15
6:30
6:45
7:00
7:15
7:30
7:45
8:00
8:15
8:30
8:45
9:00
9:15
9:30
9:45
10:00
10:15
10:30
10:45
11:00
11:15
11:30
11:45
AM
PM
Drop-off Address / Hotel Name :
Airline :
Flight Number :
Flight Arrival / Departure Time :
---Select a Time---
12:00
12:15
12:30
12:45
1:00
1:15
1:30
1:45
2:00
2:15
2:30
2:45
3:00
3:15
3:30
3:45
4:00
4:15
4:30
4:45
5:00
5:15
5:30
5:45
6:00
6:15
6:30
6:45
7:00
7:15
7:30
7:45
8:00
8:15
8:30
8:45
9:00
9:15
9:30
9:45
10:00
10:15
10:30
10:45
11:00
11:15
11:30
11:45
AM
PM
CUSTOMER INFORMATION
Your Name :
Company Name :
Mailing Address :
City :
State :
Zip Code :
Country :
Residence Phone Number :
Office Phone Number :
Cellular Number :
Fax Number :
E-mail Address :
We will send you a confirmation. Please input your correct address !
Comments :
PAYMENT INFORMATION
Type of Payment :
--Select Payment--
Cash
Travelers Cheques
Credit Card
Type of Credit Card :
--Select a Card--
Visa
MasterCard
American Express
JCB
Individual Account
Business Account
Name on Credit Card :
Credit Card Number :
Expiration Date :
(MM/YY)
758 Kapahulu Avenue #539
Honolulu, HI 96816
Phone: (808) 927-5955 Fax: (808) 921-2384
E-mail :
info@sakura-limo.com
Copyright © 2011 Sakura Limousine. All rights reserved.
