application form

Pick up locations: Warsaw, Krakow, Budapest, Vienna, Central Euro Rent A Car

ATTENTION CUSTOMERS! Filling and sending this form does "NOT" mean we have the type of car available that you need. A customer service representative will be contacting you within the next 24 hours of submitting this form by e-mail, or phone. Customer service: (905) 403-8083 or (416) 827-3515

Reserve Your Car using your CREDIT CARD

Please don't send us payment until your agent contacts you back after submitting these information!

*Your name: *Date of birth: mm/dd/yy

*Address:

*Country:

*Phone:

*Fax:

*Your e-mail:

*Employer:           *Employer's phone:

*Driver's license Nr:

*Passport Nr:    *Nationality of passport:

*Address at destination: (Europe)

*Country of destination:

*Phone at destination:

Important! Please make sure that your complete FLIGHT number is entered, thank you.

* Date of pick up:	mm/dd/yy	*Time:
* Place:		*Airline:
* Date of return:	mm/dd/yy	*Time:
* Place:		*Airline:

*

Check if you'd like to RENT a Cell Phone! Cell phone rental is $20.-USD/week ($30.-CAD/week)

Check if you need a child seat! Please indicate the age of the child!

Check if you need "Snow Chain"! Snow Chain is $30.-USD ($40.-CAD) for the entire rental.

Please write your message:

By pressing the send button below, you acknowledge that all the information you gave us is correct!

A customer service representative will be contacting you within the next 24 hours of submitting this form by e-mail, or phone. Customer service: (905) 403-8083 or (416) 827-3515

*Your name:	*Date of birth: mm/dd/yy
*Address:
*Country:
*Phone:
*Fax:
*Your e-mail:
*Employer:	*Employer's phone:
*Driver's license Nr:
*Passport Nr:	*Nationality of passport:
*Address at destination:	(Europe)
*Country of destination:
*Phone at destination: