Chris and Gina Limousines Service

Account Info

Your e-mail address:

Account Number:

Name:

Passenger:

Male/Female:

Caller:

Caller Number:

Pickup Date:

Pickup Time:

Comments:

Pickup

Flt# / Rm#:

Street#:

Street Name:

On / Corner:

Between / From:

Zone:

Tel #

Arrival:

Destination - Select ONE
	JFK Airport
	Newark Airport
	LaGuardia Airport
	Other
*If other* please provide location:**

Special Requests - Vehicle Type
	Sedan
	Bus (22-49 Passengers)
	Limo (6-12 Passengers)
	Van (15 Passengers, Back Out)

I read, understand, and accept the:
Cancellation/Change Policy - Click Here:
Check Box - Required