Payment Details - Traveling.black

This form is for those who wish to pay for the Experience South Africa 2017 trip in full.

Your payment is fully refundable for 2 weeks.

After your payment goes through it is non-refundable. If for some reason you can not go on this trip the payments you have already made can be put toward a future trip to any destination.

Housing Accommodation Options*

Double Occupancy-EXPSA($2,599 one-time payment)

Single Occupancy-EXPSA($2,899 one-time payment)

Total $0.00Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Phone Number*

Area CodePhone Number

E-mail*

I agree with the terms and conditions

Terms and conditions

Referred By

If a friend referred you they get $100!

Referred By (Name/Store/Meetup Group)

First NameLast Name