Blue Travel, Inc.    -    RESERVATION FORM    -    BRITZ Rentals Africa
            Please fax to USA Toll Free: 1-877-605-6888 or
   United Kingdom: +44-208-711-5331  |  Germany: +49-3222-690-6222
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CUSTOMER ADDRESS:                                         (please print)
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                :  ___ Mr.   ___ Mrs.
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      *Last Name:  _____________________________________________________
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     *First Name:  _____________________________________________________
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         *Street:  _____________________________________________________
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           *City:  _____________________________________________________
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     *State, ZIP:  _____________________________________________________
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        *Country:  _____________________________________________________
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  Tel +Area Code:  _____________________________________________________
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  Fax +Area Code:  _____________________________________________________
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         *E-Mail:  _____________________________________________________
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PAYMENT:
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    *Credit Card:  ___ MasterCard       ___ VISA       ___ Diners Club
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                   ___ American Express + ID __________________________
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    *Card Holder:  ____________________________________________________
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*Full Cardnumber:  ____________________________________________________
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*Expiration Date:  _______________ (Month / Year)
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This is a legally binding reservation request and I authorize Blue
Travel to disclose my personal information to BRITZ Rentals Africa.
I give permission for BRITZ Rentals Africa to charge my credit card
accordingly with the appropriate hire costs. I acknowledge that I
am the authorized card holder of this account.
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RESERVATION:         Rental Option: __________________________________
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     *Vehicle Type:  __________________________________________________
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*No. of Passengers:  ___
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*  Pickup Location:  _____________________     *Date: _________________
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*Drop off Location:  _____________________     *Date: _________________
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ADDITIONAL COMMENTS:
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City and Date                        Signature