Rental Cars - West Salem Location Only
2011 Chrysler Town & Country
     $ 65.95/day             175 miles free/day              $ .25 each add’tl
     $395.00/week        1225 miles free/week       $ .25 each add’tl
 
 
2011 Dodge Avenger
     $ 45.95/day             175 miles free/day              $ .20 each add’tl
     $275.00/week        1225 miles free/week       $ .20 each add’tl
 
 
SPECIAL REDUCED RATES AVAILABLE TO CUSTOMERS WHILE VEHICLES ARE IN FOR SERVICE AT OUR DEALERSHIP
          
          MINIVANS     $45.00/day 175 miles free per day $ .30 each add’tl
          AUTOS           $30.00/day 175 miles free per day $ .25 each add’tl
RENTAL REQUIREMENTS
1. All drivers must be a minimum of 23 years of age with valid license, Must have photocopy of  license for renter and all authorized driver’s.
2. Proof of Insurance is required. Renter’s insurance is primary should any incidence should occur.  Require photocopy of Insurance Card. We do not offer Damage Waivers. Rentals used for “business”, deliveries, personnel transportation or “for hire” are prohibited.
3. Visa, Mastercard or Discover card required for reservation & rental. Debit cards not accepted for reservations. Require photocopy of front and back of card.
4. No shows will be billed $ 25.00 unless reservation is cancelled 24 hours in advance of scheduled.
   fields are required.

Identification

Identification

Do you have a corporate account with us?  
If yes, Coporate Number  
How did you hear about us?  

Pick-up Information and Location

Pick-up Information and Location

Name of Passenger / Company  
Booked By  
(Area Code) Daytime Phone:  
(Area Code) Evening Phone:  
(Area Code) Cell Phone:  
(Area Code) FAX:  
Email:  
Address:  
City:  
State:  
Zip:  

# of Passengers  
Type of Service  
Enter any comments here:  
Vehicle Request  
Date of Service  
Pick-up Time  

If Airline, Train or Trail, please provide the following information.  

Arrival Time  
Airline/Train/Trail Carrier  
Flight / Train / Tail #  
Origin City  

If at an address, please provide the following information.  

Name:  
Address:  
City  
State:  

Drop Off Information and Location

Drop Off Information and Location

Drop Off Time  

If Airline, Train or Trail, please provide the following information.  

Departure Time  
Airline/Train/Tail Carrier  
Flight / Train / Trail #  
Destination City  

If at an address, please provide the following information.  

Name:  
Address  
City  
State  

Additional Information

Additional Information

Additional comments/info in the area below
Type of Payment  



Please note that your reservation is not confirmed until a Pischke Motors representative contacts you.
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