Fax this form to (732) 617-2217   

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 2-3 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 $_____.

American Express: copy (FRONT & BACK) of Card, DRIVER LICENSE  or PASSPORT OF THE CARDHOLDER. 

I HAVE READ, UNDERSTOOD, AND AGREED WITH THE INFORMATION ABOVE. 

SIGNATURE OF CARDHOLDER:________________________________________  DATE:_______________