CONTACT INFORMATION (STEP 1/3) Name: $name Organization: $org Office Phone: $phone Mobile Phone: $mobile Email Address: $email RESERVATION INFORMATION (STEP 2/3) Passenger's Name(s): $passenger_name Date of Travel DEPARTURE: $date_travel Date of Travel ARRIVAL: $ar_date_travel Airport DEPARTURE: $airport Airport ARRIVAL: $ar_airport Airline DEPARTURE: $airline Airline ARRIVAL: $ar_airline Flight Number DEPARTURE: $flight_no Flight Number ARRIVAL: $ar_flight_no City Leaving DEPARTURE: $city_leaving City Leaving ARRIVAL: $ar_city Pickup Time DEPARTURE: $pic1 : $pic2 ,$pic_time Time of ARRIVAL: $ar_pic1 : $ar_pic2 , $arr_time Pickup Street Address : $address Drop-Off Street Address Number: $ar_address City DEPARTURE: $city City ARRIVAL: $ar_city_leaving State DEPARTURE: $state State ARRIVAL: $ar_state Number of Passengers DEPARTURE: $passenger_no Number of Passengers ARRIVAL: $ar_passenger_no Type of Vehicle DEPARTURE: $vihicle_type Type of Vehicle ARRIVAL: $ar_vihicle_type PAYMENT INFORMATION (STEP 3/3) Card Number: $card_no Expiration Date: $exp_date Security Code: $security_code Name as it Appears on Card: $card_name Billing Address $billing_address Work Phone: $bill_phone Cell Phone: $bill_mobil Email Address : $bill_email "; $subject = "Montreal Limousine Online Reservation"; $to="info@montreallimousine.info"; //$to="kuldeep@webplanet.co.in"; $email_id="noreply@montreallimousine.info"; $headers = "MIME-Version: 1.0\r\n"; $headers .= "Content-type: text/html; charset=iso-8859-1\r\n"; $headers .= "From:".$email_id."\r\n"; @mail($to, $subject, $message, $headers); header("Location: thanks.html"); } ?> Montreal Limo ® Montreal Limousine Service Montreal Airport Limousine - Limousine. Limosine. Corporate

Montreal Limousine

Offering you the finest in luxury transportation!

CONTACT INFORMATION (STEP 1/3)

Name

Organization

Office Phone

Mobile Phone

Email Address

RESERVATION INFORMATION (STEP 2/3)

Passenger's Name(s)

Flight DEPARTURE Information

Flight ARRIVAL Information

Date of Travel

Airport

Airline

Flight Number

City Leaving From

City Arriving From

Pickup Time

AM PM

Time of Arrival

AM PM

Pickup Street Address

Drop-Off Street
Address

City

State

Number of Passengers

Type of Vehicle

Lincoln Town Car
Executive SUV
10 or 14 Passenger Van

Type of Vehicle

Lincoln Town Car
Executive SUV
10 or 14 Passenger Van

PAYMENT INFORMATION (STEP 3/3)

Note: If you already have a profile with MTL Limousine, you will NOT need to fill out the payment information.

Card Number

	Please be sure to enter fifteen (15) numbers. Your security code consists of four (4) numbers on the front of the card.
	Please be sure to enter sixteen (16) numbers. Your security code consists of three (3) numbers listed on the back of the card.
	Please be sure to enter sixteen (16) numbers. Your security code consists of three (3) numbers listed on the back of the card.