CREDIT CARD AUTHORISATION FOR FLAME OF AFRICA

Please complete and fax back to: + 27 31 762 2402 ( All Hours)

CLIENT / CARDHOLDERS SIGNATURE: _____________________

DATE: _____________

Please note there is 3 % service fee, which must be included in the total amount below

If payment is made by credit card, I warrant that the information relating to my credit card is correct and I have authorised Flame of Africa to charge my Credit card with R              -      being made up with the following amounts in respective of travel arrangements:

Please note: we do not accept American Express Credit Cards.

INTERNATIONAL CREDIT CARDS

Please send through the below with your credit card form:-

COPY OF CREDIT CARD - FRONT AND BACK - LEGIBLE
COPY PASSPORT
TRAVELERS ADDRESS (LOCAL OR OVERSEAS)

Please also indicate the amount to be processed in South African Rands as we are a south african based company this is the currency we need authorisation from you in to process payment. Currency Convertor

As a security check on most international credit cards the following details are required by foreign banks in order to obtain an approval code, please complete accordingly:

1.) Home Phone number in country of residence

2.) Mother's maiden surname

3.) Billing address

4.) Date of birth

5.) Passport number

6.) If a Master card, the VIN number (the last 3-digit number on the reverse of the credit card)

7.) If a secondary card holder (i.e. a spouse) is attached to the main credit card holder the above details will be required for them too

FLAME OF AFRICA CONTACT DETAILS
THE NATIONAL NUMBER 0861 312 312
DIRECT PHONE NUMBER +27 31 762 2424
DIRECT FAX NUMBER +27 31 762 2402
CELL 082 2945813 - Carien ( M.D)

POSTAL ADDRESS : PO Box 2511 Hillcrest 3650, KwaZulu-Natal, South Africa.
PHYSICAL ADDRESS : Shop 1, 20 Forest Drive, Kloof, Durban