 |
Mountain
Monarch Adventures
P.O. Box: 980,
Kathmandu, Nepal,
Tel: +977- 1- 4361668, Fax: +977-1-4363530 |
Authorization
for the Payment by Credit Card
I
would like to pay US$. ………
for the advance of. ……………………..….
to Mountain Monarch Adventures P/L by my VISA
/ MASTER CARD. The necessary details for this
transaction are as below:
Card
Number:
Card Expiry Date:
Amount in Words:
Cardholder’s Date of Birth:
Passport Number:
Card Holder Full Name:
Address (home/office):
Kindly receive the copy of my passport along
with this authorization form.
Signature of Cardholder _________________ Date:
---------------------
Privacy:
All information contained herein is used solely
by Mountain Monarch for purposes of charging
on your credit card and will not be released
under any circumstances.
Note:
Please add 3 % extra bank charge on credit card
payment.
Please
fax this authorization form at +977-1-4363530
[
Download
the print verson copy here ]
