Fax this form to (732) 677-3572   

 

CREDIT CARDHOLDER' S AUTHORIZATION


I, Cardholder   ____________________________________________________________________________

AUTHORIZE TO CHARGE MY CREDIT CARD LISTED BELOW IN THE AMOUNT OF  $    _________

FOR:  (  ) AIRLINE TICKET(S);  (  ) CRUISE (S);   (  ) TRAVEL PACKAGE (S);   (  ) TRAVEL INSURANCE;

$ AMOUNT IN WRITING:

________________________________________________________________________________________

for the following itinerary _________________________________________________________________
departure city departure date destination city return date

________________________________________________________________________________________

airline name and/or hotel name

 

Passenger name (s): _______________________________________________________________________

_________________________________________________________________________________________


Credit  Debit  Card # _____________ - ____________ - ____________ - ____________     

Security digits ____________        Exp. Date ______/______

Cardholder name _________________________________________________________________________

Cardholder billing addrees__________________________________________________________________

Cardholder phone' s: Home ( _______ )  _______  -  __________  Work ( _______ )  _______  -  _________


ALL PACKAGES/TICKETS ARE NON-REFUNDABLE. VALID TRAVEL DOCUMENTS MUST BE CARRIED DURING THE ENTIRE JOURNEY. PASSENGER MUST RECONFIRM RESERVATION DIRECTLY WITH AIRLINE 24-72 HOURS PRIOR TO EACH FLIGHT. FAILURE TO DO SO MAY RESULT IN CANCELLAATION OF RESERVATION. CHECK IN AT THE AIRLINE COUNTER IS REQUIRED AT LEAST 3 HOURS PRIOR TO EACH FLIGHT. CHECK IN LATER COULD RESULT IN CANCELLATION OF RESERVATION. TRAVEL AGENT(S) CARRY NO RESPONSIBILITY FOR PROBLEMS THAT ARE BEYOND AGENT' S CONTROL. IDENTIFICATION IS REQUIRED! PLEASE PROVIDE ENLARGED AND LIGHT PHOTOCOPY OF THE CREDIT CARD

IT IS STRONGLY RECOMMENDED THAT TRAVEL INSURANCE IS PURCHASED
I AGREE_____, I DECLINE____, IF AGREED, AMOUNT OF INSURANCE $_____.


(FRONT & BACK) AND PASSPORT OR DRIVER LICENSE OF THE CARDHOLDER. I HAVE READ, UNDERSTOOD, AND AGREED WITH THE INFORMATION ABOVE.


SIGNATURE OF CARDHOLDER:________________________________________  DATE:_______________