Please type in your personal details plus the amounts owing. Then print, sign & fax back to Christine at our secure office number + 27 11 793 3528 or scan & send it as an email attachment.
Please advise your bank to expect these charges so they will not impose security blocks.
We will advise you by email when the form arrives at our office. Thank you.
We prefer Mastercard, VISA and Diners and American Express on request.
Date:
I ,
hereby authorise
Wildlife Safaris to debit my credit card.
Type
of Card and Card number:
Expiry
Date:
C
V V Number:
(last 3 digits on the back of the card)