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Credit Card Authorization Form CREDIT CARD LETTER.doc by longze569

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									                                               8701 World Center Drive Orlando Florida 32821



                                  FDLE
                  CONFERENCE ATTENDEE CREDIT CARD LETTER
                                                 (PLEASE PRINT CLEARLY)
Conference Confirmation Number (s)______________________________________________________________

Name of Company______________________________________________________________________________

First Name ____________________________________ Last Name _____________________________________

Street Address _________________________________________________________________________________
                        (This is the address that your credit card statement is mailed to)

City ________________________________________ State______________ Zip Code_____________________

Phone______________________________________ Fax _____________________________________________

Email address: ________________________________________________________________________________


                QUANTITY                               TYPE OF REGISTRATION                      COST
(Please indicate number of registrations you
             will be paying for)
                                                 Attendee Registration            $ 150-Per person– Prior to June 24th

                                                 Attendee Registration            $ 175-Per person –After June 24th


TOTAL AMOUNT TO CHARGE TO CREDIT CARD________________________________________________


This letter gives the Orlando World Center Marriott Resort and Conventtion Center the authorization to charge
the credit card listed below for all charges relating to your FDLE Conference Registration list above.

I have read the above statement and understand and agree to all of the terms.

____________________________________                                     _________________________________________
Name of Cardholder         Date                                          Signature of Cardholder

    Visa _____          MasterCard _____             Diners Club _____    Discover _____   American Express ______

Card Number ________________________________________________________ Exp. Date ________________

                                         PLEASE COMPLETE FORM AND SEND TO:
                                                    NANCY PADILLA
                                                    Fax: (407) 238-8709
                                             Email:nancy.padilla@marriott.com

								
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