Credit Card Authorization Form

Credit Card Authorization Form
My Travel Consultant is*
Travel Consultant Name
Reservation Number*
Cardholder Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Select one*

DepositPartial PaymentFinal Payment
Amount of Payment:click here*
I, {cardholderName}, as the cardholder, have been informed of the details of my vacation package and related travel products and hereby authorize Expedia Cruises of Delaware to charge my credit card ${input15:number-8} as discussed with my travel consultant.

I understand that the approved charge may appear on my credit card statement directly from the supplier or tour operator, and I acknowledge that Expedia Cruises of Delaware does not collect or hold any funds from my transaction unless specifically stated.
Date*

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Date
Cardholder Signature*

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