Victoria Safaris, Africa Tour Operator
Home Page
CHARGE CARD FORM
Booking Page

Please fill in the following details for online payments and FAX the same to us. Kindly ensure that these details are NOT sent by email
for security reasons

After filling this form, please print it, sign it  and fax it to the following number:
254 20 2252015

REF:  AUTHORITY TO DEBIT CREDIT/CHARGE CARD

I hereby authorize Barclays Bank of Kenya to debit my card for the credit of Victoria Safaris, P.O. Box 10511 - 00400, Nairobi, Kenya

For the sum of US$
Being payment of
(Services to be Rendered)
My details are as given below:
 
Name in full:
My Address is  
 
City
Post Box
Country
    Zip Code    
Card Type
 
Visa
 
MasterCard
 
Card Number
 
Expiry Date
 
Passport /ID Number
My Contacts are
 
Home Phone
 
Work Phone
 
Fax
 
Email
 

***************************************************************************************

 
Signature
 
 
Dated (Todays Date)

Please Note:
  • Once the payments have been effected, we shall send the clients copy to you for your records.
  • The card company will go through their regular procedure to obtain authorization, and in doing so they may contact you personally for verification details
Copyright © 2010 Victoria Safaris. All Rights Reserved.
Email: victoria@victoriasafaris.com
Last Updated 23th December 2011
Telefax: +254-20-2252015
Mobile: +254-722-862727
Email: victoria@victoriasafaris.com
Website: http://www.victoriasafaris.com