Contact Value Plus

We will contact you within 24 hours to confirm* this reservation and to give you an estimate.**

Call us if would like to reserve a van.

                              Last Name:                      First Name:

Address:    City:    Zip Code:

E-Mail Address:

Employer:        Home Phone:         Work Phone:

Cell Phone:

Pick-up Date: Month:Day:        Return Date: Month: Day:

Pick up Time:      Return Time: 

Who is your auto insurance company?  Is that full coverage insurance?  Yes  No

Did you read our rental requirements? Yes  No    Are you interested in our CDW? Yes No

Which location would you like to pick up at? Rockford  Sycamore

What size car would you like to reserve?


Completing this form does not guarantee vehicle availability.
A Value Plus representative will either email or call to confirm
your reservation.

Comments/Questions:

Call us if would like to reserve a van.

CAPTCHA: (antispam code, 3 black symbols)

captcha image

*Incomplete forms will not receive confirmation calls.
**Estimates are approximations only and are subject to change