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RESERVATION FORM
Contact Information

 
 
 

required fields marked *

 
* Name :    
  Address 1:  
* Address 2:  
* City :  
* State/Province :  
* Zip/Postal Code :  
  Country :  
* Day Time Phone :  
  Evening Phone :  
* Email Address :  
* Car Type :  

 

 
Billing Information
 
 
* Form of Payment :  
* Name On Card :  
* Card Number :  
* Expiration Date :   / 

 

 
Reservation Details
 
 
* Date of Service   /
* Arrival, Departure, or Hourly? :  
  Airport :    
  Airline :    
  Flight Number :  
  Pick Up Time :   : :
  Passengers? :  
  Pick Up Address :  
* Destination Address :  
* Destination City :  
  Comments :
  How did you find us?  
 

For airport pickups your driver will be in the terminal (after customs) holding a sign with your name..

By submitting this form you agree to allow Roma Limousine to charge your credit card in the appropriate amount.