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Miami Int. Airport to Fort Lauderdale Hotels
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10
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1
Name
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First Name
Last Name
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2
Phone Number
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Area Code
Phone Number
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3
Email
example@example.com
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4
Date
Please type the date of the service needed
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Date
Month
Day
Year
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5
Air line and Flight number
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6
Arrival time
for airport pick ups: please type the arrival time of your flight. if you need to set a pickup time please use the comments section at the end of the questionnaire.
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Hour
00
10
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50
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10
20
30
40
50
Minutes
AM
PM
AM
AM
PM
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7
Hotel or Residence
Please type the name and address of your hotel in Fort Lauderdale
for residences just print the address
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8
Qty of passengers and service price
2 passengers $85 (Private Service)
3 Passengers $85 (Private Service)
4 passengers $85 (Private Service)
5 passengers $85
6 passengers $16 p/p = $96
7 passengers $16 p/p = $112
8 passengers $15 p/p = $120
9 passengers $15 p/p = $135
10 passengers $14 p/p= $154
11 passengers $14 p/p= $154
12 passengers $14 p/p= $168
13 passengers $14 p/p= $182
14 passengers $14 p/p= $196
15 passengers $14 p/p= $210
16 passengers $14 p/p= $224
17 passengers $14 p/p= $238
18 passengers $14 p/p= $252
19 passengers $14 p/p= $266
20 passengers $14 p/p= $280
21 passengers $14 p/p= $294
22 passengers $14 p/p= $308
23 passengers $14 p/p= $322
24 passengers $15 p/p= $336
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9
Comments
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10
Payment Information
Visa
Master Card
Discover
Amex
Visa
Visa
Master Card
Discover
Amex
CC Number
January
February
March
April
May
June
July
August
September
October
November
December
January
February
March
April
May
June
July
August
September
October
November
December
Exp Date / Month
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2030
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Exp Date / Year
CCV Code
Postal Code
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