CREDIT CARD AUTORIZATION FORM
PLEASE PRINT AND FAX TO (011)
599-544-3299
I hereby authorize Island Water
World Offshore to charge my credit card for goods or services provided.
To the attention of:___________________________________________
please print name of Island Water World representative
Card Type (Visa, MC,
AMEX):___________________________________
If paying with AMEX, please print CID on
card:______________________
Card
Number:_______________________________________________
Expiration
Date:______________________________________________
Name as appears on
card:______________________________________
Billing address of
cardholder:____________________________________
__________________________________________________________
Phone
Number:______________________________________________
Name of Boat (if
applicable):_____________________________________
Amount in US
$_______________________________________________
Cardholder’s
Signature:_________________________________________
PLEASE FAX TO ISLAND WATER WORLD OFFSHORE ALONG WITH:
-
A
PHOTOCOPY OF FRONT AND BACK OF CREDIT CARD
-
A
PHOTOCOPY OF PICTURE ID (PASSPORT OR DRIVER’S LICENSE)
YOUR ID & CARD INFORMATION WILL BE KEPT ON FILE
FOR FUTURE TRANSACTIONS
THIS TRANSACTION CANNOT TAKE PLACE
WITHOUT RECEIPT OF REQUESTED DOCUMENTS
Two St. Maarten Locations:
Cole Bay at the Lagoon Bobby’s Marina, Philipsburg
Phone:
(599) 544-5310 Phone:
(599) 543-7119
Fax:
(599) 544-3299 Fax:
(599) 542-2675
VHF
Channel 74
E-mail: sales@islandwaterworld.com