RESERVATION FORM TO SEND OR TO PRINT AND FAX US
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DEFIS AGENCY
B.P. 4076   -   97064 - SAINT MARTIN CEDEX
Tel. : 06 90 50 41 70 - Fax. 05 90 29 05 19
E-mail : defisagency@defisagency.com

R E S E R V A T I O N - F O R M
CREDIT CARD N° :
EXPIRATION DATE :
EMAIL :
DRIVER N°1 LAST NAME :
DRIVER N°1 FIRST NAME : DATE OF BIRTH :
DRIVER N°2 LAST NAME :
DRIVER N°2 FIRST NAME : DATE OF BIRTH :
ADDRESS :
TOWN : ZIP CODE :
PHONE NUMBER : FAX :
DRIVERS LICENCE N° :
DATE OF ISSUE : BY:
ARRIVAL DATE : DEPARTURE DATE :
NUMBER OF DAYS :
AIR LINE COMPANY : FLIGHT ARRIVAL TIME :
VEHICULE WISHED : RATE :
All fees due after your departure (car rental, gags, franchise, garage reparations) or any others...will be debites on your credit card. Please prepare in advance the address where you will be staying in Sint Maarten, which you will have to give to the immigration upon your arrival on the island.