7866 Whispering Palms Drive
Sacramento, CA 95823
(916) 525-2337
www.california-gospel.com
californiagospel@gmail.com
CREDIT CARD AUTHORIZATION FORM
YOUR TRAVEL AGENT NAME:
California Gospel Ministries is authorized to charge the credit card below for the following charges:
Name of Trip or Destination:
Date(s) of Trip:
Your Roommate(s) Name:
Your Roommate(s) Name:
Your Roommate(s) Name:
AMOUNT TO BE CHARGED:
Visa
MC
Discover
American Express
CC#
Exp.
Three Digits on Back of Card
American Express Four Digits on Front of Card
Print Name
Billing Address
City, State, and Zip
Phone Number
Email
Confirmation Email
Signature
Date
Signature authorizes California Gospel Ministries to charge this credit card for the charges listed above. Credit card payments
cannot be accepted over the telephone without your signature on this form.
Travel Insurance:  
Accepted       
Declined

Please fax (1-916-525-2338) a copy of the front and back of the credit card listed above and photo ID with
matching signatures.  Without this information we are unable to process the charges.
"Praise him, ye heavens of heavens, and ye waters that be above the heavens"       Psalm 148:4


CALIFORNIA GOSPEL MINISTRIES
© 2006 -2017 California Gospel Ministries - All Rights Reserved
CALIFORNIA GOSPEL MINISTRIES                                   CALIFORNIA GOSPEL COMPANY POLICIES
SACRAMENTO, CA 95823
                                  
(916) 304-2246 OFFICE                                                 
(916) 525-2337 FAX
                                                                                  FORMS
                                       
                                                                                  


CALIFORNIA GOSPEL MINISTRIES