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If you are requesting service with less than 24 hours notice, please call 978-532-8488. Otherwise a Michael's Limousine representative will contact you shortly to confirm. Form will not submit unless items in red are filled in.

Name:
Address:
City: State: Zip:
E-mail:
Telephone:
Best Time of Day to Contact You:

VEHICLE INFORMATION


Number of Passengers:


Type of Vehicle Requested:


Type of Service Needed:


LOCATION & TIME


City: State:
Pick Up Address & Details: Drop Off Address & Details:
For Airport Pickups/Drop Offs Please Include Airport Info, Airline Name, and Flight Number

Date of Service: Day: Month: Year:
Pick Up Time: EST:
Drop of Time: EST:

Special Instructions: (if applicable)
(i.e., Purchase Order Number, Reference Number, Car Seat Request, Special Directions, etc.)
Form of Payment:
American Express    Visa    
Master Card              Discover
Corporate Account


   

          



          161 Lynn Street Peabody, MA 01960 978-532-8488 renee@michaelslimousine.com

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