EmailMe Form - Credit Card Authorization Form for Phone Payments

Client Full Name As Shown On Card *

First Last

IMPORTANT: The cardholder should be the one to complete this form!

Email *

Billing Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Please enter the address that is on file with the card.

Payment Details

I have provided my full card details to my Travel Advisor over the phone and am submitting minimal details here for the purposes of acknowledging my authorization of the payment using the details provided.

This payment is for the purpose of: *

Ex: "Deposit for reservation 1234567"
If not including the reservation number, please describe the trip this payment applies to.

Authorized Amount *

$ Dollars . Cents

Payment Type *

Last 4 digits of Credit Card ONLY *

Do NOT put the full number, only the last four digits!

Authorization of Charges *

I hereby authorize Cruise Planners to use my credit card information to pay for my reservation in the amount entered above.

I confirm that: *

I am an authorized user of this credit/debit card, and I will not dispute any payment of fees under this Authorization.

Cancellation Policies *

I understand that in the event of a cancellation the travel supplier can assess penalty charges. I will not hold Cruise Planners or the advisor liable for these charges.

Agreement of Terms: *

By submitting this authorization, I affirm that I have read and agreed to the Booking Terms and conditions, including agency and supplier cancellation terms, located at Joyfultravelplans.com/terms

Signature

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