PLEASE PRINT CLEARLY

AUTHORIZATION FOR TICKETING - CHEQUE

I, ______________________of_____________________________ hereby authorize AVILA TOURS LTD. to issue tickets and will send the amount of $____________on agency cheque#___________ within 24 hours of the faxing this form. I am aware that the documents will be released when the cheque has been processed. I am also aware that if departure is within 14 days, the cheque must be certified. Please complete agent/agency information below.

AUTHORIZATION FOR TICKETING - CREDIT CARD

I, _________________ of______ _________________ _hereby authorize AVILA TOURS LTD. to apply the amount of $__________________to my client's credit card towards the charges described below, and confirm the clients' card holder's authorizations to make these charges. I confirm that we have the client's signature on file for this purpose. Should my client decline these charges at a later date, this agency accepts full responsibility for these charges:



NAME AS IS APPEARS ON CREDIT CARD

_______________________________________________________________________________

CARD TYPE, NUMBER & EXPIRY DATE

_______________________________________________________________________________

CARD HOLDER SIGNATURE (OR) AUTHORIZING AGENT SIGNATURE

_______________________________________________________________________________
TICKETS AND/OR DOCUMENTS WILL NOT BE RELEASED WITHOUT SIGNATURE

THIS PORTION MUST BE FILLED IN REGARDLESS OF METHOD OF PAYMENT

AGENCY NAME:_____________________________________________________________________

ADDRESS:________________________________________________________________________

TELEPHONE:_______________________________ FAX:____________________________________

EMAIL:__________________________________________________________________________

AUTHORIZING AGENT SIGNATURE (OWNER or MANAGER):

_____________________________________________________


ACCEPTANCE: Through your payment to us for travel services, you are acknowledging your acceptance of our Terms & Conditions

PASSENGER INFORMATION
Passenger Names & Amount Per Person
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

UPDATED 12.30.04

10316-124 Street, Edmonton, AB, T5N 1R2, Canada
Toll Free: 1-800-661-2221 Tel: (780) 482-3427 Fax: (780) 482-6900
Email Us: sales@avilatours.ca

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