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Rental Booking Request
First Name
Last Name
Email
What vehicle are you wishing to rent?
Street Address
City
State / Province / Region
ZIP / Postal Code
Country
How long have you been driving uber?
How long have you been driving uber?
I don't currently drive for Uber
0-1 Year
1-2 Years
2+ Years
Have you previously rented a vehicle for ridesharing?
Have you previously rented a vehicle for ridesharing?
Yes
No
Have you had any at fault accidents in the last 3 years?*
Have you had any at fault accidents in the last 3 years?*
Yes
No
Have you had any speeding fines or infringements in the last 3 years?
Have you had any speeding fines or infringements in the last 3 years?
Yes
No
How long do you wish to rent for?
How long do you wish to rent for?
1 to 2 Months
2 to 3 Months
3 to 4 Months
4 to 6 Months
More than 6 Months
Send