Safa Travel

9520 Boulevard L'Acadie Suite 221 Montreal, QC H4N 1L8
Tel: 1-514-332-0137
Email: info@safatravel.com

Credit Card Authorization

Please complete this form and return it via email, mail or drop off at our office. With a copy of your Credit Card and any ID (mandatory).

 
*Travel Agent's Name: _____Safa travel  services inc ________________________________________________
*Passenger(s) name:   FAMILY NAME FIRST NAME
  1. ________________________ ________________________
  2. ________________________ ________________________
  3. ________________________ ________________________
  4. ________________________ ________________________
  5. ________________________ ________________________

*Itinerary:

Origin: ____________________ Destination: ____________________
Departure Date: ____________________ Return Date: ____________________
Airlines: ____________________    


*Cardholder Name:
(AS shown on the credit card): _________________________________________


*Credit Card type: Visa Master Card American Express