Long-Term Car Hire Application

 

Personal Details:

 

Name:

 

Tel:

 

Email:

 

Address

 

Suburb:

 

State:

 

Postal Code:

 

Vehicle Details:

 

Model:

 

Doors: Choose Option 2 Door 4 Door Not Important

 

Transmission: Choose Option Automatic Manual Either

 

Term: Choose Option 6 Months 1 Year 2 Years 3 Years

 

Insurance: Choose Option Insured through Thrill Rider (extra $16 per week) Self-insured

 

Other requirements:

 

Will you be using the car for business: Choose Option Yes No

 

Employment Details:

 

Current Employer:

 

Employment Length: Choose Option Less Than 1 year 1-2 Years Over 2 Years

 

Average Weekly Salary:

 

Average Weekly Expenses: