Trip Rsvp Form

Dear Sirs, In order to charge your credit card and in accordance with the security measures taken by credit card companies – please fill in the following form in your own handwriting and sign. Please send us this sheet by fax to the attention of: LAURA FRIEDMAN To fax number: +972 3 9727555 Authorisation for Credit Card Charges Name of Client:………………………………………………………………………….. We authorise KENES Tours –to make the charge of USD……………………… ………….. For Services ………………….…………………………………………………………… ……………………. ……………. ……………………………………………………………………………………………… ……………………… Credit Card details to be charged: Type:

Visa / MasterCard / Diners / AMEX

Number: Expiration date: Name of Card holder: Address: (as per Credit card records): Telephone number: Security digits (on the back of the credit card): Date: SIGNATURE of Card holder:

Kenes International Building, Airport City 70151, P. O. Box 56 Ben-Gurion Airport 70100, Israel Tel: +972 3 9727500, Fax: +972 3 7555, Email: [email protected], Website: kenestours.com