London Cell Phone Rentals Rental Form

Please Print Clearly

Client Last Name ______________________________________First Name____________________________

Address ______________________________________________________________________________

Address Line Two_______________________________________________________________________

City _____________________________State or Province_____________________Country________________

Telephone at Home________________________________CELL Phone________________________________

Fax _____________________________________________email ____________________________________

Scheduled day of departure from your home  ________________________

Scheduled arrival day back home_________________________________

Your charge will begin on your scheduled departure day and end the day after your scheduled arrival day back home.  You will be allowed two extra days to overnight the telephone back to our office.  If the telephone is not in our hands withing two days following the return day you will be charged at $10 per day for overtime.  Sample  Depart June 1, Return June 7 = 7 days  Phone charge would be for one week  Phone due back in our office June 9.  Overtime charges begin June 10.

There is a one week minimum rental.  Extra days are at $7 per day. 

Telephone rental is requested for ______________days (include day of departure and day of arrival home)

Cost calculated by client _______________________ 

Security/damage deposit                               $150        This security deposit is returned following the return of the telephone.  Insure the return.

Insurance Option  @ $5 per day  ________________

One £5 Top Up Card                                    $10

Shipping and Handling                                    $25

Total                                        ___________________

Payment by Credit Card      Card #  (Visa and MasterCard Only)  ____________   ______________    ______________   -______________

Expiration Date   _______month     __________year

I have read this form and agree to the terms.   Signature_______________________________________________

  Please fax this form to 1 973 729 2940 or mail to American Dream Vacations, 412 East Shore Trail, Sparta, NJ 07871  USA