Please fill the following form for a coupon account application request.
It is important that you mark the proper type of account box, so we can forward a copy of the appropriate form via Postal Service, Fax or Email.
Champlain Taxi charges a nominal fee for administration of accounts.

Note: All information is kept in the strictest of confidence.

Champlain Taxi reserves the right to reject any applications that does not meet with a positive credit verification