Lixoudis Bakery

Wedding & birthday cakes

Fira Santorini

Tel: + 30 6944803339

IN ORDER TO MAKE YOUR PAYMENT FOR THE PROVIDED SERVICES FROM OUR COMPANY EASIER, WE OFFER YOU THE POSSIBILITY TO PAY BY CREDIT CARD.

TO GIVE US THE LEGITIMATE RIGHT TO TRANSFER YOUR PAYMENT TO OUR BANK ACCOUNT, WE KINDLY ASK YOU TO
PRINT THIS AUTHORIZATION FORM,
FILL IN THE FOLLOWING PERSONAL DETAILS AND RETURN IT TO US VIA FAX OR EMAIL.

 

FILL IN THE FOLLOWING PERSONAL DETAILS.

NAME:

 

 

 

ADDRESS:

................................................

 

 

POST CODE:

................................................

 

 

COUNTRY:

................................................

 

 

TELEPHONE:

................................................

MOBILE:

................................

FAX:

................................................

 

 

E-MAIL:

................................................

 

 

TYPE OF CREDIT CARD:

 

VISA

WITH NUMBER: .............................

 

MASTER CARD

WITH NUMBER: .............................

 

     

       CCV NUMBER( the three last digits on the back of your card)  .......

 

 

 

      EXPIRATION DATE:.....................

 

 

 

 

 

 

 

 

 

 

 

 

 


THE UNDERSIGNED DECLARES HEREWITH THAT NIKOS SIRIGOS, HAS MY PERMISSION TO TRANSFER   ---------  EUROS  FROM MY CREDIT CARD FOR A TOUR THAT WILL TAKE PLACE ON:

 

Number of people:..Agreed price:..

We accept cash, visa & MasterCard.

 

DATE SIGNED:

..................................

PLACE SIGNED:

..................................

CARD HOLDERS SIGN:

..................................