Cancun Getaways
Fax Back Credit Card Approval Form
Print This Form
Please use this form to pay for your vacation by credit card. Fax back (732-263-0251) or email this form ( michelle@cancungetaways.com) to me and I will process your credit card. Faxing is more secure than emailing your credit card information. Please note that you will see two charges: One from Palace Resorts and the other from Cancun Getaways.
Date: __________________________
Description of Travel: _____________________________________
_____________________________________________________________
_____________________________________________________________
Total Amount: _________
(Circle Card Type): Visa – Master Card - Discover
Name on Card: _________________________
Card #: _____________________________ Expiration Date: __________
C V V Number:________________ (3-digit number on back of Visa, MC, Discover)
Card Billing Address: _____________________
_______________________________________
_______________________________________
Signature: ______________________
Thank you,
Michelle A. Bixby
Please Fax to me at: 732-263-0251 1-888-387-7468
UPON RECEIPT AND ENTERING INFORMATION IN CREDIT CARD PROCESSING, THIS RECEIPT WILL BE SHREDDED BEYOND RECOGNITION.