EmailMe Form - Tour Credit Card Authorization Form

Traveler's Name *
First Middle Last
Full Name EXACTLY as it appears on passport or government-issued ID
Billing Address *
Address Line 2
City *
State *
Zip Code *
Cell Phone Number *
### - ### - ####
Email Address *
Cardholder's Name *
Exactly as it appears on card
Type of Card *
Credit Card
Payment Amount (Contact Jackie if unsure of amount due.) *
Notes
Signature *
Clear
I hereby authorize Jackie Wolfskill of Dream Vacations (a division of World Travel Holdings) to charge the credit card provided for travel services rendered. I understand that submitting this form does not process my payment automatically. The information will be stored on a secure server and retrieved upon login. Dream Vacations will send a confirmation once the payment has been successfully processed by the vendor.
When you're finished, please click Submit below.