To pay the deposit by credit card, please print this page,
complete it and send it by mail or fax with: 1) A copy of
your credit card (both sides) and 2) A copy of your driver's
license or other ID, so that we can verify your signature.
Without them, the credit card company will not process this
authorization.
CREDIT CARD AUTHORIZATION
I, _______________________________authorize Forester Instituto
internacional to charge my VISA/MC card, No.__________________
expiration date _________________ for (amount in numbers)
US$ _______________ (amount in words) US dollars _____________
______________________________________________________________
as payment for _______________________________________________
______________________________________________________________
______________________________________________________________
Signature ______________________________ Date _______________
Address _____________________________________________________
Zip Code __________________ Country _________________________
Tel. ______________________ Fax _____________________________
E-mail ______________________________________________________
To secure your registration, fill out, sign and fax this authorization
form, toll free fax number: 1-888-803-2252 or sign it and email it to
forester@racsa.co.cr
