• Ruth Adams

    Stratford Mall, 1067 Ontario Street, Stratford, Ontario N5A 6W6

Credit Card Authorization

For your protection, each time you authorize us to charge an amount to your credit card, we require you to complete and sign this form indicating your approval to debit your credit card with the amount authorized.

All fields marked with asterisk* are mandatory

 

Trip Information

Traveler Information

 

Contact Information

 

Credit Card Billing Details

Billing Information

 

Credit Card Information

(?)

Visa / MasterCard / JCB / Switch / Solo

Flip your card over and look at the signature box. You should see either the entire 16-digit credit card number or just the last four digits followed by a special 3-digit code. This 3-digit code is your Card Security Code.


American Express Credit Card Users

Look for the 4-digit code printed on the front of your card just above and to the right of your main credit card number. This 4-digit code is your Card Identification Number (CID). The CID is the four-digit code printed just above the Account Number.

 

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