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Text File  |  1993-04-03  |  2KB  |  62 lines
  1.  
  2. ________________________________________________________________
  3.                     Mendenhall Auto Center Rent-A-Car
  4.                     8725 Mallard St.
  5.                     Juneau, Ak 99801
  6.                     907-789-1386 VOICE
  7.                     907-789-7098 FAX
  8.                     1-800-478-1386 (in AK)
  9.  
  10. Name:_____________________________________________
  11.  
  12. Adrs:_____________________________________________
  13.  
  14. City:_____________________________________________
  15.  
  16. Home Phone:_____________________Wk.Ph.________________________
  17.  
  18. Licence No.__________________
  19.  
  20. State:________________________
  21.  
  22. Soc. Sec. No._____________________________________
  23.  
  24. Employer__________________________________________
  25.  
  26. Emp Adrs._________________________________________
  27.  
  28. Emp.City,ST.Zip:__________________________________
  29.  
  30. Local Residence:__________________________________
  31.  
  32. Local Ph. No._____________________________________
  33.  
  34.  
  35.  
  36. Reserv.Dates& Time:_______________________________
  37.  
  38. Type of Rental:___________________________________
  39.  
  40. Payment: _________________________________________
  41.  
  42. Credit Card:______________________________________
  43. CC No.      ______________________________________
  44. Exp. Date:________________________________________
  45.  
  46. Signature:________________________________________
  47.  
  48. Airport Arrival?_______________Flgt #:_____________
  49.  
  50. Ferry Arrival?______ Hotel Pickup:_________________
  51.  
  52. Bed/Brkfast:_______________________________________
  53.  
  54. Notes: ____________________________________________
  55.  
  56. ___________________________________________________
  57.  
  58. ___________________________________________________
  59.  
  60. From EPAC's Vacation Alaska VOLI No.1 2nd Quarter Issue
  61. ____________________________________________________
  62.