Atlantic Limousine Service

Affiliate Online Application
Thank you for your interest in becoming an Atlantic Limousine & Transportation Vendor. Please provide us with your company information by completing the online application below.

Required fields are marked with * asterisk.

First/Last Name: *

Title:

Company Name: *

Toll Free Phone Number:

Local Phone Number: *

Fax Number:

Emergency Number:

24 Hour Cell Phone:

Address: *

City: *

State: *

Zip Code: *

Contact Email: *

Web Site:

Year Established:

Federal Tax ID/SS:

President / Owner:

General Manager:

Dispatch Manager:

Reservations Manager:

Accounting Manager:

Is your office staffed 24 hours a day? Yes    No

Do you have 24 hour dispatch / reservations? Yes    No

Can you receive and confirm reservations 24 hours a day? Yes    No

How do you receive your reservations?

By what methods does your company confirm reservations?

Can reservations be confirmed within 2 hours? Yes    No

What Limousine Software does your company use?

What is your no-show policy?

What is cancellation policy?

Vehicle Type Quantity Year Make
Model Airport
Rate Hourly
Rate

Executive Sedans

Limousines (6-10 Pass)

Luxury SUV's

Vans

Mini-Coaches

Motor Coaches

Other

Airport Tax%:

Parking:

Phone:

Tolls:

Greeter:

Fuel Surcharge:

Discount:

Portal Charges:

Please list all other additional charges:

Does your company give affiliate discounts? Yes    No

Affiliate Discounts:

Can we setup a billing account with your company? Yes    No

Can you bill us within 24-48 hours after the job is completed? Yes    No

Comments:

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