Uptown Limousine
Service
1-607-723-0374
1-877 - 2UPTOWN
FAX: 607-762-5467
Please fill out this FAX reservation form on-line, then click
the "PRINT" button
below and Fax this form
to: 1- 607-762-5467
This FAX form is to be used for
Uptown Limousine Service reservations ONLY
For non-airport service, please type your reservation request in the comment box
below
First
Name*:
Last
Name:
Street Address*:
City:
State*:
Zip:
Country*:
Phone*:
Mobile
Phone*:
*
Your Email*:
* REQUIRED
Street Address
or Airport
Name:
*
Address2
or Airline
Name:
*
City or
Arriving From:
*
State/Providence or Flight No.:
*
Zip/Postal Code
or Arrival
Time:
*(example:15:30)
Destination: *
Other:
No.
Passengers: *
Handbags: *Suitcase:
Type of
Car: *
Date of
Pickup: *
Time of
Pickup: *
Credit Card Type: *
Credit Card Number: *
Exp Date *: mm/yy)
Name
on Card: *
Card Billing
Address:
City:
State:
Zip:
Card Holder
Phone: *
By
signing this limo service form you agree that (1) you are
the credit card
holder and (2) that you are requesting the
limousine service listed
above and (3) that you are authorizing this card to be used for the
Uptown Limousine
Service requested.