EUROCOSMOS RENT A CAR

RESERVATION FORM



Last name:
First name:
Address: 
City: 
State/Prov: 
Country:
   Postal Code:  Your e-mail:
Include country & area codes. Tel:   Fax: 

    To better answer your inquiry, please fill in the following information:

 Is this an Inquiry or Reservation? Please select one. 
Enter preferred Car Make and Model/Type: 

Please indicate all dates bellow,  in DD/MM/YY format, e.g.: 25/6/98

 Preferred dates:  From:  to:  No of days: 


* COMPLETE THIS SECTION ONLY IF YOU ARE CONFIRMING A RESERVATION *

We can not accept a confirmation unless you complete this section.

Visa Master card
Your name as it appears on the Credit Card: 
 Credit Card number:   Expiry date: 

If you don't feel comfortable sending your credit Card details through the Internet,
then you can print and Fax this Document to us, at the number indicated.
Please, see Terms and conditions of "Advanced Bookings" on this page.

 

 Comments: please enter any comments or preferences below.

PLEASE NOTE:All fields indicated in red must be completed.


 
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