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CREDIT CARD AUTHORIZATION FORM |
Please print and fax this form
Please
include a legible photo copy of the front and back of your credit card so that
we may verify the signature.
The address below must match the billing address for the credit card.
| To: |
Village Travel |
| Fax: |
1-952-854-1767 |
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Attn: |
Internet Reservations Department |
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I authorize Village Travel
Service to charge my credit card (below) for air, hotel, tour and/or
related travel services. I understand all cancellation penalties imposed by
airlines, tour companies
and cruise companies and any service fees
resulting from purchases through Village Travel are my sole responsibility
to pay. I agree to pay Village Travel in the form of my authorized credit
card number below for said services. |
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Traveler's Name: |
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Credit Card
Number: |
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Expiration Date: |
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Amount: |
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Security Code: |
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Address: |
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Card Holder
Signature: |
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Date: |
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