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Chartering Group
First Name*
Last Name*
Address Line 1*
Address Line 2
City/Town*	State*
Zip Code*	(with four digit number if known)
Day Phone*	••Extension•
Night Phone	••Extension•
E-mail*	(no caps)
Fax
Pick-Up Point* "Origin"
Destination City & State*
Departure Date/Time* Please note: it is important to specify both date and time for accurate quoting.
Return Date/Time*
(Return Time is the time you want to be back at origin or pick-up point.)
Time you want to start to return home:
Bus type you require:* (choose below)
56 Passenger Coach 47 Passenger Coach 25 Passenger Mini-Coach VIP Coach Elite Trolley
What is the Itinerary or schedule for the trip planned? (List places you wish to visit and stops you wish to make.)*