Secure Form Reservation
Record Rent a Car Costa Rica www.comsegmat.com
Fleet and Rate
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Reservations
Please complete the secure form for their reservation.
* Required Fields
Personal Information
* Name
* E-mail
Country
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Afghanistan
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Otro
# adults?
# Childrens?
Ages?
Arrival Flight Nº
Airline Company
Telephone
How did you find us?
No estoy seguro
Google
Yahoo
MSN
AOL
Overture
Lycos
HotBot
Alta Vista
Excite
Metacrawler
Other engine
Recommend
Already Knew
Previous Client
Service Information
Type of Car
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Economic compact Spark 5 pax or Similar
Economic Sedan Aveo 5 pax or Similar
Economic Compact 4x4 Terios 5 pax or Similar
Suv Mid-Size 4x4 Rav4 5 pax or Similar
Suv Mid-Size 4x4 Outlander 5 pax or Similar
Suv Premiun 4x4 Terracan 7 pax or Similar
Minibus H1 - 12 pax or Similar
Suv Mid-size 4x4 Montero 5 pax or Similar
Suv Full-size 4x4 Montero 7 pax or Similar
Suv Premiun-size Suburban 9 pax or Similar
Compact 4x4 Bego 5 pax or Similar
Suv Mid-Size 4x4 X-Trail 5 pax or Similar
Suv Premiun 4x4 Vitara XL7 7 pax or Similar
Other
Additional Driver
Yes
Child restraint System
Yes
Roof racks
Yes
Cell phone ?
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No
Yes
GPS ?
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No
Yes
PICK UP:
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Month
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Feb
Mar
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May
June
July
Agoust
Sept
Oct
Nov
Dec
Year
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2008
2009
Hour
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00:00
00:30
01:00
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02:00
02:30
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05:30
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07:30
08:00
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10:00
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11:00
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12:00
12:30
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AM
PM
DROP OFF:
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30
31
Month
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Jan
Feb
Mar
April
May
June
July
Agoust
Sept
Oct
Nov
Dec
Year
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2008
2009
Hour
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00:00
00:30
01:00
01:30
02:00
02:30
03:00
03:30
04:00
04:30
05:00
05:30
06:00
06:30
07:00
07:30
08:00
08:30
09:00
09:30
10:00
10:30
11:00
11:30
12:00
12:30
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AM
PM
Pickup Location
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San Jose Airport
Pavas Airport
Liberia Airport
San Jose Location
Guapiles City
Arenal City
My Hotel
Other Place
Not Secure to be advise
Dropoff Location
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San Jose Airport
Pavas Airport
Liberia Airport
San Jose Location
Guapiles City
Arenal City
My Hotel
Other Place
Not Secure to be advise
Credit card Information
* Type Credit Card
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VISA
MASTERCARD
* Credit Card Number
* Expiration Date
Month
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01
02
03
04
05
06
07
08
09
10
11
12
Year
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2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
* Secure Code
Additional Comments
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Location: Residential Villas de Ayarco, Cartago, Costa Rica / Tel/Fax: Cel. (506) 8546 8941 - (506) 4030 0705 / Ced. Jur. 3-101-445-440
Mail:
csmw@comsegmat.com
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