By Pixel tours
Travel Agency Manager: Nikos Sirigos
Main Office Fira - Greece - Zip Code 84700
164
Argyroupolis Athens 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 ------ EUROS FROM MY CREDIT CARD FOR A
TOUR THAT WILL TAKE PLACE ON: