VEP CREDIT CARD AUTHORIZATION FORM

VEP Associates Professional Services, LLC

VEP Associates Travel
CREDIT CARD AUTHORIZATION FORM

I give authorization to VEP Associates Professional Services, LLC dba VEP Associates Travel to charge my credit card for the agreed services.
This form is used to process a payment or monthly payments per the amount indicated below and the option to purchase vacation protection. Recurring monthly Payment options can be selected below.
THIS PAYMENT COVERS THE FOLLOWING GUESTS, if applicable
BILLING ADDRESS

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PAYMENT OPTIONS: Select One:
Payment Amount

prevnext( X )
USDPayments will be processed by VEP Associates Professional Services / VEP Associates Travel or directly with the trip's supplier
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
COMMENTS:

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

VEP Associates Professional Services, LLC