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CREDIT CARD PAYMENTS Your Full Name: Email Adrress: Phone Number: CREDIT CARD DETAILS Credit Card: VISA Credit Card Number Expiration Date : - Month - 1 January 2 February 2 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December - Year - 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Name of Cardholder: Card ID Number:   (on the back of your card , locate the final 3 digit number) Comments:

Messonghi tk49080 , Corfu island (Kerkyra) , Greece
Tel: 0030 2661075096  &  Fax: 0030 2661075096
Website: www.corfu-holiday-choices.com    E-mail: info@corfu-holiday-choices.com