Credit Card Authorization Form
Booking ID or Confirmation #
*
Full Name
*
First Name
Last Name
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Purpose of Transaction (select all that apply)
Vacation Deposit
Vacation Payment
Vacation Lesson Planning
Research/Planning Fee
"I authorize Frantastic Trips and Travel LLC to charge my credit card for the authorized amount. I understand that my information will be saved to file for future transactions on my account." PLEASE TYPE YES IN THE BOX BELOW.
*
Signature
*
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Amount Approved
Notes
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Should be Empty: