Surname
*
Vehicle
Mercedes Benz S-Class
Mercedes-Bus 518 16 seats
Mercedes-Bus 313 16 seats
Mercedes-Sprinter 8 seats
VW Caravelle TDI 7-seats
First name
Number of
persons
Company
Dates
from - to
Phone
Additional
information
Fax
e-mail
*
House No.
street
Town/post code
Country
*
These fields are obligatory
You may print this form and send it to us by fax or letter
Tel. +49- 3362- 49 02
Fax +49- 3362- 2 72 25
Individueller Chauffeur Service
Wolfgang Zipfel
Kienkamp 21
15537 Erkner
Germany
Date: Signature:
