A SPANISH LANGUAGE SCHOOL IN COSTA RICA
 
 
CREDIT CARD AUTHORIZATION
  

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 ______________________________________________________


      Mailing address: Forester Instituto Internacional
J.B.C. SJO #7545, P.O. Box 025240, Miami, FL 33102, USA
               Fax (Costa Rica): (506) 2225-9236