Credit Card Authorization Form
and fax this form until you have been asked to do so by one of our agents.
This authorization form must be completed by the credit card holder and faxed along with a copy of proof of your identification (ie: drivers license, passport, utility bill.) If a third party is charging your trip, a photo copy of the credit card is also required. Please print, complete and fax to 240-248-7567. This is for the consumer's protection.
I, ______________________________________, authorize Connie George Travel
Associates to submit my charge in the amount of $________ to:
___________________________(supplier) for travel to: _____________________
(destination) on ___ /___ /___ - ___ /___/___ for the these travelers:
_____________________________________________________________________.
Account Number: ___________________________________
Cardholder: ________________________________ Expiration Date:___/___
Credit Card Billing
Address: __________________________________________________________________
Signature: ____________________________________ Date: ____________________
Agent handling vacation: ____________________