PromLimosDFW.com Credit Card Authorization

All prom packages are for a minimum of six consecutive hours. 

 Sorry,  we cannot drop you off and come back later pick you up.

Please provide the information as requested below:

TYPE OF CREDIT CARD* AMEX [   ]   MASTERCARD [   ]   VISA [   ]

KEEP THIS CARD ON FILE FOR FUTURE BOOKINGS YES [   ]       NO [   ]

CARD ISSUED TO: ____________________________________________________________
***PLEASE PRINT NAME OF CARD HOLDER AS IT APPEARS ON THE CARD
PRINT COMPANY NAME AS IT APPEARS ON THE CARD
___________________________________________________________________________

CREDIT CARD NUMBER ______________________________________________________

EXP. DATE _________AUTHORIZED SIGNATURE __________________________________

BILLING ZIP CODE _____________ PHONE NO. OF CARD HOLDER: _________________

AMOUNT OF CHARGE $ _________.____
 

THIS CHARGE IS FOR:

High School:____________________________________ PROM Date: ___________________

School Colors:____________________________________________________

Please print form and fax completed form to 972-291-5828 or mail to P.O. Box 516, Cedar Hill, Texas 75106-0516

This form must be received in order to guarantee the reservation.

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Allpoints Limousines    Phone:  214.212.0981    •     E-Mail: Info@PromLimosDFW.com