Jordan Travel Enterprise

Credit Card Payment Form

 
  PLEASE PROVIDE THE FOLLOWING CONTACT AND PAYMENT INFORMATION
   
  [This is a payment form only. If you have not completed a reservation form, please either visit our website: http://www.jordantravelenterprise.com,
call us at (407) 924-2760 or email us at eva@jordantravelenterprise.com ]
Travel Information  
Group Name  
Travel or Sailing Date  
Guest Name if different from Cardholder  
Billing Information  
Salutation  Mr. Mrs. Miss Ms.
First Name  
Last Name  
Phone  
E-Mail  
Mailing Address: Street  
City  
State  
Zip  
Date of Birth (mm/dd/yyyy)  
Nationality  U.S. Citizen U.S. Legal Resident
Country of Citizenship (if not U.S.)  
Credit Card Authorization
 For your protection as well as ours, by completing the billing section of the registration, you are giving Jordan Travel Enterprise authorization to charge your credit or debit card for your travel arrangements. If you agree, then please check this box
   
Payment Information
PAYMENT AMOUNT  
Credit cardholder’s name  
Credit card number  
Card Type (Visa, MC, AE, Discover)  
Credit card expiration date  
Card Approval Code (3 digit code on the back of your card)  
You must be the authorized user of the credit card in order to place this order.
Press the Submit Payment button only once.