EmailMe Form - GTG Vacations - Payment Authorization

Primary Traveler / Client's Full Name *

First MI Last

Booking Confirmation Number

My Travel Advisor is: *

Credit Card Information

Full Name - as it appears on credit card to be used in this transaction: *

Cardholders Phone Number *

### - ### - ####

Client/ Cardholder's email address *

Client/Credit Card Billing Address (Verify for Accuracy before submitting)
Transaction will fail if the address is not the same as the billing address. *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Type of Credit Card to be Used in this Transaction: *

Credit Card *

Amount to be charged today *

$ Dollars . Cents

Select a payment option: *

Partial Payment (after initial deposit)

Final Payment

Pay in Full at Booking

Planning Fee ($50/non-refundable)

Domestic Travel Fee ($125/non-refundable)

Group Travel Planning Fee ($500/non-refundable)

Air Ticket Only Fee ($25 per person/non-refundable)

Other

IF THIS IS THE INITIAL DEPOSIT PAYMENT PLEASE CONTACT YOUR TRAVEL ADVISOR BEFORE PROCEEDING.

Please note payments marked as "Paid in Full" and/or" Final Payment" will not be processed UNLESS the CORRECT amount of the full cost of the vacation/travel charges will be paid in full... and/or final payment will result in a zero balance on the account. Please call me at 314.482.1799 to confirm your payment(s) if you have not received already received this information from your Vacation Designer.

GTG Vacations Card Authorization - Card Usage

I have accepted the quote given to me by GTG Vacations and authorize GTG VAcations usage of said credit card on my behalf for services quoted and accepted. I understand this is a disclosure of business practices and permissive payment agreement for the purchase of travel services. I agree that payment may be made direct to selected travel suppliers on my behalf by GTG Vacations; paid in prorated amounts not to exceed the sum total of approved charges. I understand Debit Cards often impose "Daily Charge Limits" and multiple payments may be needed to complete the full balance due. I am aware of any potential Cancellation, Refund and Surcharge Policies and Fees by suppliers and agree not to dispute or charge back any of the below signed for and acknowledged charges without proper course of action. I understand that GTG VAcations will impose the following charges when contractually applicable: all reservations are subject to Cancellation Fees of $50 per traveler and will be applied to the provided credit card account within 72 hours of cancellation. GTG VAcations will not release personal information to ANY parties not listed on you finalized travel quote and will apply due diligence in maintaining records in a secure, safe location.

I have read and accepted the terms and conditions on the original booking and deposit form. *

I have read, understand, and agree to the above stated terms.

Any comments regarding amount to be charged to authorized credit card today:

I consent to provide an electronic signature rather than a handwritten signature in connection with my Credit Card authorization. I submit my signature by typing my name below and checking the “I agree” box. I understand that my electronic signatures will be binding as though I had physically signed this document by hand. I agree that a printout of this authorization may be accepted with the same authority as the original. *

I agree

Electronic Signature *

Date Signed *

MM / DD / YYYY

Signature (Please use physical signature when possible)

Clear