CC Authorization Form

Alluring Asia: Credit Card Authorization Form

You've reached a retired form:
Alluring Asia recently updated our methods for online payments of security deposits and payments for your upcoming journey.

Please contact us at (800) 420-5993 or email info@alluringasia.com for assistance in processing payments.

Thank you

The Alluring Team
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American Express Visa Mastercard
Full Name as it appears on your card *

Prefix First Name Middle Name Last Name
Credit Card Billing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary Phone *

Area Code Phone Number
E-mail *
Alternate Phone

Area Code Phone Number
Name of passenger if other than the cardholder

Prefix First Name Middle Name Last Name
Relationship to cardholder
Authorized amount to be applied to: *

Trip deposit Final Payment Travel Insurance Domestic Air Partial Payment Other
*

I hereby acknowledge and authorize Alluring Asia to charge the amount of entered above to the credit card provided for service/documents to be issued for my trip upcoming journey.
*

I have read and agree with the terms of the cancellation policy below
The following fees per person are applicable for all cancellations prior to departure.

Booking date up to 90 days prior to departure:

Cancellation fee is 100% of Air + 100% of Insurance + 100% of Security Deposit

89-44 days prior to departure:

Cancellation fee is 25% of total tour price

43-29 days prior to departure:

Cancellation fee is 50% of total tour price

29-0 days prior to departure:

Cancellation fee is 100% of total tour price
Sign below

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Electronic Signature Consent
By applying my electronic signature to this form, I agree that my electronic signature is the legally binding equivalent of my handwritten signature on paper. I will not, at any future time, claim that my electronic signature is not legally binding or enforceable. By electronically signing and submitting this form, I 1) acknowledge that I have read and fully understand the terms and conditionsas well as the payment schedule and cancellation penalty above; 2) voluntarily agree to be bound by the terms and conditions; and 3) certify that I am 18 years of age or older and that I am the parent/guardian of all guests under the age of 18 that I have indicated responsibility for above. My signature applies to all pages of this contract
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Alluring Asia: Credit Card Authorization Form