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Anrede:
selection
Mister
Miss
Company
First name:
Last name:
Street/No.:
Postal/City:
/
Date of birth:
(DD.MM.YYYY)
E-Mail:
Telephone:
Driver's license number:
Date of issue:
Issued in:
Address in Menorca:
Car type:
selection
Opel Corsa 3 doors
Opel Corsa 3/5 doors air-cond.
Seat Ibiza 5 doors air-cond.
Opel Astra 5 doors air-cond.
Fiat Punto Cabriolet
Serena 8 places, air-cond.
Zafira 7 places, air-cond.
Vivaro 9 places, air-cond.
Piaggio 7 places
Jumpy 9 places, air-cond.
Child seat:
0
1
2
3
4
5
(up to 3 years)
Seat increase:
0
1
2
3
4
5
(from 3)
Delivery date:
(DD.MM.YYYY)
Place:
selection
Cala Galdana
Ferreries
Mahon Airport
Santo Tomas
Other (Comments)
Time:
Return date:
(DD.MM.YYYY)
Place:
selection
Cala Galdana
Ferreries
Mahon Airport
Santo Tomas
Other (Comments)
Time:
Arrival:
(date)
Flight Number :
Time:
Departure:
(date)
Flight Number :
Time:
Payment:
selection
cash
credit card (Visa, Eurocard)
Comments:
(Child's seat, etc.)
optional second driver
First Name:
Last Name:
Date of birth:
Driver's license number:
Date of issue:
Issued in:
Yes, i read and accepted the
Terms and Conditions
.
