EmailMe Form - FAM & Experience Trip Card Authorization Form

Submit your credit card information via this secure Cardholder Authorization Form.

This data will remain valid and be stored in an encrypted vault, kept on file, and used to process agreed-upon transactions until otherwise notified in writing via email to annaliza@pinnacletravelpartners.com

Your information is never sold, rented, or otherwise provided to any third parties (except when completing payments on your behalf) and we will do everything in our power to keep your data secure.
FAM Trips & Destination Experience Trips
FAM Trips & Destination Experience Trips *
Cardholder Information
Cardholder Name *
First Middle Last Suffix
Please enter exactly as shown on the card.
Company Name (if applicable)
If using a company card and the company name is on the card instead of a person's name, enter it here.
Email Address *
Phone Number *
### - ### - ####
Credit Card Information
*

Card Number

Protected in vault Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
Billing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Authorization and Acknowledgment
As the Cardholder or an Authorized User, I authorize Pinnacle Travel Partners, LLC to collect, store and use this data for the agreed-upon transactions.

I acknowledge that this Cardholder Authorization will remain valid until I notify Pinnacle Travel Partners of otherwise in writing via email to annaliza@pinnacletravelpartners.com

I agree not to chargeback or otherwise dispute any agreed-upon transactions and I acknowledge that Pinnacle Travel Partners, LLC reserves the right to seek legal action against me for doing as such.
Cardholder Signature *
Clear
Print Name *

FAM Trips & Destination Experience Trips

Cardholder Information

Credit Card Information

Authorization and Acknowledgment