Credit Card Authorization Form
Guest Name:
Arrival Date: Departure Date:
Confirmation Number(s): _______________________________________
Name of Card Holder:
Card Holder’s Telephone Number:
Card Holder’s Email:
Billing Address:
Credit Card Type: _____VS _____ MC _____DS _____AX
Credit Card Number:
Expiration Date:
Billing Information
______All Charges _______Room & Tax ______Other/Estimated Total____________________
Card Holder’s Signature: _________________________________________________________________
Please complete form and fax to 269-888-4801
Or email to
[email protected] Holiday Inn West Kalamazoo
1247 Westgate Drive
Kalamazoo, MI, 49009
269-888-4800