Invoice

Please Return By E-mail Or Mail

Your Chariot Awaits

Name
First Last
Booking Person
Phone
Address
Street Address Address Line 2 City State ZIP Code
Email
Event Name
Event Date
Event Location: Pick Up
Drop Off
Time(s) Of Use:
From: To:
Antique Car:
Make Make Make
Antique Car:
Model Model Model
Antique Car:
Year Year Year
How Did You Hear About Us?
Mailing Address: Palm Springs Classic Cars, c/o John Shadrach
P.O. Box 10449, Palm Desert, CA 92255
E-mail Address: [email protected]
Payment By Cash or Check
Total Cost:
Deposit
Date Deposit Paid
Balance Due
Customer or Agent Signature

From:	To:

Make	Make	Make

Model	Model	Model

Year	Year	Year