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AGENT DETAILS

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AGENTS NAME *

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CUSTOMER DETAILS

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HOME ADDRESS1 *

HOME ADDRESS2

CITY *

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PHONE (HOME) *

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DATE OF BIRTH *

(All drivers must be over 21)

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BOOKING DETAILS

TYPE OF VEHICLE *

DAILY RATE *

NUMBER OF DAYS *

START DATE *

PICK UP LOCATION

DROP OFF LOCATION

AGENTS COMMISSION 20%

(Calculated on the daily rate only, not on the one way fee or the security bond)

ONE WAY FEE

EXTRAS

  MATTRESS $125

 

  CAMPING KIT A $80 (FOR 2 PEOPLE)

 

  CAMPING KIT B $100 (FOR 4 PEOPLE)

CUSTOMER LICENSE DETAILS

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LICENSE NUMBER

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CUSTOMER LICENSE DETAILS - DRIVER 2

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CUSTOMER LICENSE DETAILS - DRIVER 3

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EXTRA DETAILS