This form only documents your authorization for your advisor to process payment on your behalf.

Your card will not be charged until the advisor processes the payment to the travel supplier.
  • IMPORTANT: The cardholder should be the one to complete this form!
  • - -
  • Please enter the address that is on file with the card.
  • Payment Details

    Please provide payment details below
  • Ex: "Deposit for reservation 1234567"
    If not including the reservation number, please describe the trip this payment applies to.
  • $ .
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