MAKE A PAYMENT - Global Navigator Travel

Travel Payment Authorization

Payment Information

Please answer the questions below so that we may meet your travel expectations.

Today’s Date

Travelers #1 Full Name (As it appears on your Credit Card)

Phone/Mobile

Date of Birth

Trip Destination

Departure City Airport(s)

Trip Date (put “1st” for the day)

Card Type

Credit Card #

Expiration Date (place “1” for day)

CVV

Billing Address (Please include City, State and Zip Code)

Payment Amount (put amount you would like to put towards your trip)

Notes (put any specifications of your payment here)

I verify that I am the authorized user of the card I am going to submit payment with and waive my right to a chargeback, stop payment, reverse, or recollect a trip payment already made. Global Navigator Travel reserves the right to collect all additional costs, fees, and expenses associated with such chargeback, reversal, or recollection including, without limitation, attorney fees.

I verify I am the authorized user of this card and waive my right to a chargeback.

By initialing, you authorize Global Navigator Travel to submit the amount you indicated above towards your vacation. (Please initial below)

Date / Time