By Pixel
tours Travel Agency Manager:Anna
Vafiadou Nikos Sirigos
Main Office
Fira - Greece - Zip Code 84700
Fira Santorini
Greece
Tel: +30 22860
28115 - Fax: +30 22860 28116 (from USA please add 011 in front) - Mob: +30
6944803339
License
Number:1144E61000026101 ΑΦΜ:109293426
IN ORDER
TO MAKE YOUR PAYMENT FOR THE PROVIDED SERVICES FROM OUR COMPANY EASIER, WE
OFFER YOU THE POSSIBILITY TO PAY BY CREDIT CARD.
TO GIVE US THE LEGITIMATE RIGHT TO TRANSFER YOUR
PAYMENT TO OUR BANK ACCOUNT, WE KINDLY ASK YOU TO PRINT THIS
AUTHORIZATION FORM, FILL
IN THE FOLLOWING PERSONAL DETAILS AND RETURN IT TO US VIA FAX OR
EMAIL.
FILL IN THE FOLLOWING
PERSONAL DETAILS.
NAME:
ADDRESS:
................................................
POST
CODE:
................................................
COUNTRY:
................................................
TELEPHONE:
................................................
MOBILE:
................................
FAX:
................................................
E-MAIL:
................................................
TYPE OF CREDIT
CARD:
VISA
WITH NUMBER:
.............................
MASTER CARD
WITH NUMBER:
.............................
CCV NUMBER( the three last digits on the back of your card)
.......
EXPIRATION DATE:.....................
THE
UNDERSIGNED DECLARES HEREWITH THAT NIKOS SIRIGOS, HAS MY PERMISSION TO
TRANSFER ---100--- EUROS FROM MY CREDIT CARD FOR A
TOUR THAT WILL TAKE PLACE ON:
