Credit Card Authorization Form
For your protection, as well as mine, I will need the following information as authorization to charge your travel arrangements.
Name as it appears on the credit card *
Your answer
Phone Number *
Your answer
Billing Address *
Your answer
Departure Date of Travel *
MM
/
DD
/
YYYY
Return Date of Travel *
MM
/
DD
/
YYYY
Type of Credit Card *
Credit Card Number *
Your answer
Credit Card Expiration (Month/Year) *
Your answer
Credit Card Security Code *
Your answer
Electronic Signature *
Your answer
Date *
MM
/
DD
/
YYYY
Signature Terms and Conditions *
Required
Surcharges
Please note that it is not unlikely that an airline/cruise line will request additional payment for a fuel surcharge even if payment is made in full.
Oh The Places To Go is an independent travel agency affiliated with Dugan's Travel.
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