Reservation CONFIRMATION Request

Maui ECO Rental Car Reservation Form

Todays Date Todays Date / MM / DD YYYY
Name of primary driver Name of primary driver First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number you will have on Maui.
Email MAKE SURE IT'S CORRECT
Arrival Date Arrival Date / MM / DD YYYY
Arrival Time Arrival Time : HH MM AM/PM
Arrival Flight info. Airline and number. (If picking up at airport.)
If coming to Kahalui Harbor on a cruise, or not coming into the OGG airport explain here:
Departure Date (returning the car date) Departure Date (returning the car date) / MM / DD YYYY
Expected Departure / flight Time (or return time if NOT catching a flight) Expected Departure / flight Time (or return time if NOT catching a flight) : HH MM AM/PM
Preferred vehicle
Price quoted in email
Drivers license number
Drivers license EXPIRATION and STATE
Insurance that covers your rental car. Policy number and expiration.
If credit card covers you, then write in "credit card."
Do you want the CDW. Added insurance $35/day, with $500 deductible. Not liability.
(If you are not covered by your credit card, or have personal/business insurance, you are required to be covered through somewhere.)

Do you want the CDW. Added insurance $35/day, with $500 deductible. Not liability.
(If you are not covered by your credit card, or have personal/business insurance, you are required to be covered through somewhere.) no yes
Additional Drivers: NAME, LICENSE NUMBER and EXPIRATION, and state, and insurance info. ($5/day for more than 2 drivers, unless in same family and have same insurance)
NO ONE UNDER 21
Date of birth or acknowledge you are over 21
Credit Card number. 25% run now for deposit. Remainder usually run the day you pick up the car. Cancel within 7 days of rental and it is 50% total.
expiration date
security code
Name or address if on credit card if different from above
How many people in your group
Do you want a cooler, boogie boards, sand toys, left in the car for you to borrow. (Free)
Where are you staying on Maui
How did you hear about us
Any comments, questions, concerns?
Have you driven this type of car before? (Some cars might need a little explanation, such as Electric cars, or keyless cars, or toggle shifters. We want to make sure you are 100% comfortable and can explain a little more about them, if you would like. )
Spam Protection. Please answer this simple question.
In the number 73627, what is the 3rd digit?