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CREDIT CARD AUTHORIZATION FORM
Complete the information below to authorize Travelwise International to charge your credit card.
To receive a copy, enter your email address below.
Reservation Number
Your Reservation Number can be located in your invoice.
Agent's Name:
Please select
Aiza
Alvin
Jomarie
Keisha
Marie Cris
Cardholder's Name:
*
First
Last
Passenger Name:
If there is more than one passenger, please input their names in the space provided
Example: GONZALES/JOSEPH
Amount to be charged:
*
$
Dollars
.
Cents
Credit Card
*
Card Number
Expiration
MM
/
YY
CVV
What is this?
3 or 4 digit number printed on the back/front of your credit card
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.
By clicking yes, you agree for Travelwise to authorize payment on your behalf.
*
Yes
No
Agree to Terms & Condition
*
Yes, I agree
I, the client, have read, understood, and accepted the conditions below detailed in the Travelwise International Inc. Agreement. Client understands and accepts that Travelwise International Inc., acts as the agent (not the principal), subject to terms and conditions of all its suppliers (airline, hotel, cruise, train, any other transport, tour operators, and all other travel suppliers); understands and accepts that cancellations are nonrefundable (without cancel-for-any-reason insurance when available and purchased by Client or without travel insurance for covered reasons when available and purchased by client); and understands and accepts that change fees will apply. The client confirms that Client is an authorized signatory for the credit card listed above.
To view our terms and conditions
Travel Insurance
Yes, I would like to protect my travel investment
No, I understand the risks and decline to purchase travel insurance
Signature
*
Clear
Today's Date
MM
/
DD
/
YYYY
Email Confirmation
If you would like to receive an email confirmation, please enter your email address below.
Email Adresss
Confirm