Credit Card Authorization Form - Astoria Dickinson
Complete the form below to make payments for your friends, family and corporate guests. Upload a high res copy of your drivers license.
GUEST DETAILS
Guest Name
Check In Date
Check Out Date
Total Charges Approved ($)
Email
Phone
CREDIT CARD DETAILS
Name on Credit Card
Card Type
Credit Card Number
Expiration Date
CVV
BILLING ADDRESS
Address
City
Zip Code
State
Upload Drivers License
Upload File (.DOCX or .PDF files only.)
