Fax Form for Credit Card Details
Orders with Quo Vadis Travel & Services GmbH
Authorization to PAG Serviços Golfs Lda to debit

By completing this form, you are authorizing PAG Serviços Golfs Lda, with whom all our bookings are made, to debit your credit card in respect of the Quo Vadis order number quoted.  The amount(s) debited will be as agreed with you in our order confirmation.

Once your credit card is debited, we will acknowledge your payment.  (Credit cards are not debited for golf bookings until start times have been confirmed.)

The credit card details will only be used in respect of this order.

Order in the name of

QVTS Reference Number e.g. 123VM

Phone number (please include country code)

Fax number

From the front of the card

Credit card type (VISA or Master/Eurocard)	Full Name on the card
16 digit card number	Expiry Date (month/year)

From the back of the card

Proof Number (3 or 4 digits)

As this is a mail order transaction, we do need to verify you have the card in your possession and require the 3 or 4 digit 'Proof Number' that only appears on the back of the card.  It is often proceeded by all 16 digits or just the last 4 digits of the card number.

Cardholder's postal address

Please enter the address as it appears on your credit card statement, including the post code.

Your comments

 

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Signature

Please fax this form to +351 289321697. (00351 289 321697 from most European countries.)