Total Travel of Tulsa

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.) ***

 

Image