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  First Name        
  Last Name        
  Address 1        
  City        
  State:     Zip:        
 
  Preferred Contact Method:   E-Mail  Phone       
 
  Repeat Customer   Yes  No      
 
  E-Mail Address        
  Best Contact Number    Or       
  Best Contact Time 9AM  10AM  11AM  12PM  1PM 
2PM  3PM  4PM  5PM  6PM 
 
  Destination        
  Type of Rental  





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  Pick-Up Date (mm/dd/yyyy)            
  Return Date (mm/dd/yyyy)            
  Your comments or requests for further information  
 
 
 
 

Toll Free: (800) 591-RITE
Phone: (802) 863-1870		 1655 Marshall Avenue
Williston, VT 05495 		Email Us
Fax: (802) 863-2213
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