Credit Card Charge Authority
DIVERSION DIVE TRAVEL
96 Smith Ave, Allambie, NSW, 2100, Australia
ph:+61 740390200, fax +61 740 390 300
booking terms and conditions

Personal Details:
First Name
/Initial: 		 *
Last Name:
 *
Address:  *
City:
 *
State:  
Zip/Area Code:
 *
Country:  *
Email:
  *
Phone:  *
Fax:

Payment Details:
Card Type:
(credit card surcharges apply)
Name of card holder:
 *
Card Number:  *
Expiry Date:
 /  *
mm       yyyy
CCV No.:  
(3 to 4 digits)
Issuing Bank:
 *
Service:

Billing Address Of Card Holder: (if different from above)
Address:
City:
State:
Zip/Area Code:
Country:
 
Phone:
Fax:

 We strongly recommend comprehensive travel insurance cover.
*
More information on online travel insurance

  Promo Code:  

Fields marked * need to be filled or selected

"By sending this credit card authorisation, I confirm that I know and acknowledge the booking terms and conditions and authorise DIVERSION DIVE TRAVEL to use the above credit card to pay for travel services purchased by me."

Verification Sum

Enter the sum of 8 + 8