***Credit Card Authorization/Disclosure Form***

I, ____________________, do hereby authorize Apple Vacations to

charge my credit card number _______________________, exp. ____, in the amount of $___________.  I have read and agree with the terms and conditions of the Fair Trade Contract in the back of Apple Vacation’s brochure including cancellation penalty and AV-OK Vacation Security Plan items___________ (initial).

 

My billing address and phone number are as follows:

 

_______________________________________________________________

_______________________________________________________________

__________________________________________

 

My booking information is as follows:

 

Booking/Reservation #:_____________

Destination: ______________________

Date of Travel: ____________________

Passenger Name (s):___________________________________

                                ____________________________________

 

 

 

__________________________          ___________

Signature                                                     Date  

Fax completed form to your travel agent or Apple Vacations Accounting at 610-359-6561.

** The cardholder’s signature is to be obtained for EVERY credit card transaction.  Travel Agents are responsible for verifying the identity of the credit card holder and will be held responsible for false information or failure to produce a signed document or UCC form upon the request of Apple Vacations or the issuing bank.**