Credit Card Authorization

In order to confirm your reservation for a seat on the flight to Dijon, we need your credit card information as a guarantee.  Please fill out the information below and mail or fax to me.  This must be in my office on or before the deadline posted on the Ithaca in Dijon page, along with your registration to ensure a seat on the group flight.   No charges will be made to the card until final payment UNLESS you cancel after the cancellation deadline.  If you cancel after the deadline, your card will be charged $100.00 for the penalty for canceling after the deadline.

 

I,_________________________________________, authorize Baker Travel  to charge my credit card for the following services for myself and/or  

passengers with a different name_______________________________________

Card Type:     Visa     Mastercard     Discover     Diners Club     American Express

Card Number___________________________________________________________

Expiration Date_________________________________________________________

Name as it appears on the card_____________________________________________

Billing address for the card________________________________________________

Security code (last 3 digits on the back of the card or for AX 4 digits above name on the front of the card________________

Signature______________________________________________________________

 

 

Please return by fax to 607-272-0175

 

You may also mail this authorization to:

 Marcia Ervay

1146 Danby Rd

Ithaca, New York 14850