www.activecarrental.co.za

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Booking Form: “FIELDS MARKED WITH AN * MUST BE COMPLETED TO SUCCESSFULLY SUBMIT THE FORM”

Find us at 12 Marine Circle, Blouberg, Cape Town, Western Cape

CUSTOMER Name: *
SA Address: *
SA Tel nr: *
Cell nr: *
E-mail: *
ID / Passport nr: *
Country *
DRIVER: 1 - Name: *
License nr: *
Date / Place issued: *
ID / Passport nr: *
SA Address: *
Tel nr: *
E-mail: *
DRIVER: 2 - Name:		(If applicable)
License nr:
Date / Place issued:
ID / Passport nr:
SA Address:
Tel nr:
E-mail:
DELIVERY DETAILS: *	CT Airport City Centre Office Strand Office Blouberg Office Other	Where you want Active Car Rental to deliver the car to you.
Specify other or Flight nr:
Date from: *
Time *
Date to: *
COLLECTION DETAILS: - Place *	CT Airport City Centre Office Strand Office Blouberg Office Other	Where you want to return the car.
Specify:
Time *
Vehicle: *	Group AGroup BGroup CGroup DGroup DAGroup EGroup GGroup IGroup J
Rate Quoted:
Quotation Reference nr:
Payment Method: *	VisaMasterAmexDinersclubDebit CardCash
Type the black script *