Travel Agent Credit Card Authorization Form

Travel Agent Credit Card Authorization Form
TRAVEL PURCHASE AUTHORIZATION For Non-Website Purchases
To complete your transaction and confirm your arrangements, your signature on this authorization is required. This form is NOT required for electronic purchases you complete yourself on our website,www.vacationsensei.com, or its affiliates. Charges are payable ONLY to the airline,hotel, resort, tour operator, cruise line or other travel supplier. Independent Travel Agents may not accept and process charges through any other account, or accept checks, cash or other forms of payment.

TRAVEL INSURANCE WAIVER For your protection, Travel Insurance is strongly recommended and available upon request from Vacation Sensei. You can enroll for travel protection for Medical Expenses, Baggage Delays/Loss, Trip Delay or Cancellation, and other coverages. Vacation Sensei encourages and can arrange coverage for you. For an insurance quote and purchase, please contact your travel agent/advisor.

To decline recommended travel insurance, your signature on this insurance waiver form is required. Final travel documents (tickets, vouchers, etc.) cannot be sent to you prior to receipt of the signed insurance waiver
Destination/Booking Number
Trip Start Date

MonthDayYear
Cardholder Name*

First NameLast Name
Email Validator*
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
PLEASE CHECK WHICH APPLIES AND SIGN BELOW*

I have ACCEPTED and authorized the travel purchases below, including travel insurance, and I am aware the insurance premium is not refundable.I have ACCEPTED and authorized the travel purchases below, and I understand that by signing below, I am DECLINING TRAVEL INSURANCE. I have read and understand all cancellation charges and change fees related to the above travel arrangements, and that I may not be entitled to a full refund should my travel plans change. In case of cancellation of nonrefundable airline tickets or other arrangements, I agree to pay all applicable penalties according to the travel supplier’s rules.
Signature*

Clear
I hereby authorize Jose Torres,Vacationsensei.com,Cornerstone Travel or the travel supplier that my booking is through to charge my credit card for travel reservations and I confirm that the information for the credit card and billing address is complete and accurate.
Cardholder Signature*

Clear
Date*

MonthDayYear
Date Completing This Form
Card Issuer*
Card Number *
Card Will Be Encrypted
Exp. Date*

MonthDayYear
CVV*
Please verify that you are human*
Should be Empty: