Bethany Travel Payment Request Form

Please use this form if you would like to make a payment towards an existing trip. Payments will be processed Monday through Friday during business hours (9am-5pm)

Lead Traveler First Name *

Lead Traveler Last Name *

Phone Number *

Email Address *

Please select the travel agent you are working with: *

Name on Credit Card *

Credit Card Type *

Credit Card Number *

Security Code *

Credit Card Expiration Date * +

Amount to be charged: *

Billing Address *

Address Line 2

City *

State *

Zip Code *

By e-signing below, I have read and accept the terms of the Credit Card Authorization Form. I am aware if I do not receive confirmation from Bethany Travel within 48 business hours I am to reach out to the agency directly to follow up. This is just a secure site to submit information. *

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Notes: Please note that we do not charge a booking fee but do have a $50 per person cancellation fee if the vacation is cancelled after deposit is made. We are paid after our clients travel so this helps cover our cost should you need to cancel after deposit is made. Thank you, Bethany Travel