Fax the completed form to:
+1 612-377-9239
 

REQUIRED: This authorization form must be accompanied with:

• A photo copy of both sides of the credit card
• One of the following forms of identification:
  • The identification page of your passport clearly showing your photo and signature.
  • Both sides of a valid driver's license issued within the USA.
     

I __________________________________
              Name of Cardholder- Exactly as it Appears on Card

hereby authorize AWA Travel / Carrousel Travel American  Express
 

to charge my _____________________credit card _______________________________
                                   Credit Card Company                                            Credit Card Number

 ____________________________ 
               Expiration Date

The billing address and phone number for the card is: 

___________________________________________________________________________

________________________________________________    _______________________,
            Full Billing Address                                                                                            Telephone Number                           
 

Payment is for (check one):

1  Airline Ticket(s)               1  Vacation Tour               1 Other

To be issued for the following individual (s):
 

_______________________________________________________________________
                                                                Full name(s) of passenger(s) or tour/cruise participant(s)
 

_______________________________________________________________________
                                                                 Full name(s) of passenger(s) or tour/cruise participant(s)
 

RESPONSIBILITY: The undersigned cardholder acknowledges that the information contained
            herein is correct and meets with cardholder’s approval.
 

________________________________________                   _____________________
                

We must receive the completed form and ID prior to ticketing.