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Credit Card Authorization Form


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Please complete this form and return it to us by fax or mail. Do not submit this form by e-mail. Please include clear, legible photocopies of signature & photo pages of passports for all passengers.

Fax to: 215-572-9803   Mail to: Friendly Planet Travel, Inc., P.O. Box 505, Jenkintown, PA 19046

Name of passenger (if other than cardholder):

_______________________________________________________________________

Your name as it appears on your credit card:

______________________________________________________________________

Card Number _____________________________________ Exp Date  _____________

Security (CID) Number __________
(Visa, Master Card, Discover CID # is 3-digit on back of card. AMEX CID # is 4-digit on front of card.)

Billing address for this card (if other than home address):

_______________________________________________________________________

_______________________________________________________________________

I authorize Friendly Planet Travel, Inc. to charge my/our credit card for (circle one):

Deposit   Insurance   Final Payment**     Authorized Amount:___________________

Tour Name: _______________________________________________

Dates of Travel: ____________________________________________

***Please note that we will charge your credit card for the amount indicted above on the day we receive this authroization form.***

I understand that my deposit is non-refundable.

Signature: _________________________________________ Date: _______________

Phone: _________________________

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