EFTA00289153.pdf

AUTHORIZATION FORM :ATS O handling AGENT GENERAL WINAIR Here is your itinerary: From To Flt# Date Time From To Flt# Date Time The total ticket(s) price is: EUROS LOCATOR #: You have 36 hours to issue your tickets after that this proposition should be cancelled To confirm this reservation and purchase your tickets Please fill out the form below and return it by fax to : AUBIN TRAVEL SERVICES & HANDLING Authorized a• ent for WINAIR SBH Fax from US Mail : Web site: Purchaser first name: Last name: Address: Telephone: Fax: Email: Passenger!: Last Name: First Name: Age (if child): Passenger2: Last Name: First Name: Age (if child): Passenger3: Last Name: First Name: Age (if child): Passenger4: Last Name: First Name: Age (if child): Passenger5: Last Name: First Name: Age (if child): Passenger6: Last Name: First Name: Age (if child): I authorize AUBIN TRAVEL SERVICES & HANDLING to charge my credit card: (NO AMEX) 0 VISA 0 MASTER CARD CARD NUMBER: •-• • • • • • • • • • • • • • •-•-•-•-• DATE OF EXPIRATION: / SECURITY CODE: / / (ONLY LAST 3 nicarsi Card holder's signature: Date: * For an e ticket refund winair charges 25 euros of penality per coupon flight unused (25 euros for an one way and 50 euros for a round trip). EFTA00289153