Total Travel of
www.total-travel.com
Credit Card Authorization Form
I,
____________________________________________________, hereby authorize Total
Travel of Tulsa to make charges in the amount of $__________________________ to
my Credit Card in consideration for airline tickets and any other travel or
transportation services or products as requested by me or authorized users of
this credit card.
I fully understand the airline
tickets and other travel services or products are non-refundable and/or are
subject to penalty fees in the event changes need to be made or services and/or
products need to be cancelled.
Credit Card Type: Visa
___ Mastercard ___ American
Express ___ Discover ___ Other ___
Credit Card Number: _____________________________ Expiration
Date: ______________
Billing Name (as it appears on credit card):
_________________________________________
Billing Address (where credit card statements are sent to):
_________________________________________
_________________________________________
_________________________________________
Daytime Telephone Number: __________________________
Evening Telephone Number: __________________________
Cardholder signature: ___________________________________________________________
Date: ________________________
*** PLEASE PRINT THIS PAGE OUT AND FAX TO 918-492-4795.
PLEASE INCLUDE A COPY OF THE CREDIT CARD, BOTH FRONT AND BACK, ALONG WITH YOUR
PICTURE I.D. (DRIVER'S LICENSE, MILITARY I.D., ETC.) ***