– Credit Card Detail

Credit Card / International Debit Card Authorization Form

I ____________________________________________ S/o ___________________________ hereby authorize M/S Sunland Education & Immigration Consultants, SCO 260, Sector 32 D, Chandigarh to use my credit card details for the payment of  ________________________________ fees for Mr/Ms/Mrs. _____________________. The details of my credit card/ International Debit Card are as below:

Card Type                       :              Visa/ Master Card/ Mastero

Card Number                :              _____ / _________ /_____________ /____________

Expiry Date                    :              ___________ / ___________ (mm/yy)

Cardholder Name       :              ____________________________________

CVV Number                 :              ________ (Last 3 digit on the back side of card)

Signature of Card Holder                                Signature of Visa Applicant

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