CREDIT CARDHOLDER'S AUTHORIZATION
Please print form, complete and return to Pilgrim Tours, PO Box 268, Morgantown, PA, 19543
or Fax to Pilgrim Tours at 610 286 6262

Attention Pilgrim Agent:_____________________________________________________________

Destination or Tour name: _{______________________________________________________________________}

Date(s) of Travel: _{_________________________________________________________________________________}

In lieu of my Credit Card Imprint, I ___________________________________ hereby authorize Pilgrim Tours
                                                   (PRINT NAME OF CARDHOLDER AS SHOWN ON CREDIT CARD)
    
To charge my:             _  Mastercard                _  Visa              _  Discover    
         
Credit Card Number______________________________________ 

Security Code (3 digits, back of card)___________      Exp. Date: ________________________ 

In the Amount of: $ _________________________________  for payment of travel arrangement for myself and/or

Full Name of Passenger if other than Cardholder: ___________________________________________________

Card Billing Address: _____________________________ City: ____________ State: _____  Zip: _________

Phone No:_____________________________________ Fax No.: _____________________________________

Email: _____________________________________________________________________________________


Signature below indicates acknowledgement of charges described hereon. Payment in full to be made when billed or in extended payments in accordance with standard policy of company issuing credit card.


____________________________________________________________________________________________
Cardholder's Signature                                                                                                                       Required Date