Remittance Advice for Credit Card Payment

Please complete and fax to 033 345 8918

PLEASE DO NOT E-MAIL

Invoice Number:
    
Type of card:
    
Card Number:
    
Expiry Date:
    
Card Holder Name:
    
CVC Number:
    
Amount Authorised:
    

 

Card Holders Signature __________________________________

All prices are subject to change without prior notice.
Please ensure your booking name is reflected on your proof of payment.

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