Tourism 
Credit Card Info
Credit Card Info
Credit Card Info
Wednesday, 13 May 2009 07:58
 | Al–Aytam Corp. Commercial Center | |
| AMMAN - JORDAN | ||
| Tel | + 962 6 552 14 93 | |
| Fax | + 962 6 552 14 95 | |
| : This e-mail address is being protected from spambots. You need JavaScript enabled to view it | ||
| website | www.neptune-tours.com | |
CREDIT CARD AUTHORIZATION FORM | ||
| NAME : | …………………………………………. ( As in Credit Card ) | |
| NATIONALITY : | …………………………………………. | |
| PASS. NO. : | …………………………………………. | |
| ADDRESS : | …………………………………………( Bank Mailing Address) | |
| ………………………………………… | ||
| ………………………………………… | ||
| TEL. NO. : | ………………………………………… | |
| CREDIT CARD # : | ………………………………………… | |
| C.V.C. 2 : | ................... | |
| TYPE : ( VISA ) ( MASTER CARD ) ( AMEX ) | ||
| EXPIRY DATE : | …………………………………………. | |
| TOTAL AMT : | …………………………….....................( Please Specify Currency ) | |
| EQUIVALENT : | ……………………………………........ ( JOD ) | |
| - For our use only. | ||
| APPROVAL : | ……………………........................ (For Credit Card Company Use Only) | |
| DATE : | …………………………………………. | |
| SIGNATURE : | ………………………………………… | |