
A Division of Creative Travel Management
522 E. Dunlap
Fax - 602-997-2276
Date of Travel: Shuttle Date(s) & Time(s):
Passenger
name(s). Please print:
Today’s Date:
I, ____________________________________(card signer print
name), authorize Creative Travel Management/Open Road Tours &
Transportation of Phoenix, Arizona to charge my credit card for services listed
above:
Credit Card #
_____________________________ Exp.
Date: __________________
Security code (see back of the card for 3-digit
code) _________
Billing address for credit card:
______________________________________________
Amount to be charged: $______________________