Universal Credit Card Charge Form

  
ORDER INFORMATION:

China Visa Application: 


Single Entry: _______________________________


Double Entry:    ______________________________


Multi Entry (6 months) : ______________________________
Multi Entry (12 months): _______________________________ PAYMENT INFORMATION: Name ____________________________________(as shown on CREDIT CARD) Credit Card Type: Visa |_| Master |_| Credit Card Number: ____________________________________ Expire Date: _________________ Mailing Address ____________________________________ ____________________________________ Phone Number ____________________________________ Email Address ____________________________________ No. of Passports ____________________________________ Card Holder Name ____________________________________
Card Holder Signature ____________________________________ Billing Address ____________________________________ ____________________________________ I authorize to pay the total fare and delivery fee. This total charge may appear on my credit card statement as separate items from various airlines and travel agency.I hereby authorize FLYGREATCHINA or our official partners : /XO TOURS/ROYAL SCENIC CANADA to charge my card in the amount of CAD$____________ or USD$___________ for payment of china visa services fees
Toll Free Fax Number : 1-866-886-1041
Email:flygreatchina@hotmail.com Mailing address: CANADATRAVELSERVICE.com Suite 415, 1095 Mckenzie Ave Victoria BC V8P 2L5 FlyGreatChina e travel ALL BC Reg # 34848 Kindly reminder:: Please often check your credit card statement for protecting your payment You can contact us for payment checked. Please call (250)8843389 or email: flygreatchina@hotmail.com