|
Confirmation Number |
............................................................ |
|
In lieu of my credit card imprint, I (card holder) |
............................................................ |
|
Hereby authorize WTC to charge my (credit card name) |
............................................................ |
|
Credit card number |
............................................................ |
|
- (expiration date) |
............................................................ |
|
- (credit card 800 number) |
............................................................ |
|
In the amount of $ |
............................................................ |
For that payment of transportation of myself and/or
(name of passenger(s))
if other than card holder |
............................................................
.........................................
|
|
For my itinerary as follows: (trip routing) |
............................................................ |
|
Billing address of the credit card |
............................................................ |
|
Phone
|
(h) .........................(w) ......................... |