Kindly complete this form by filling in the fields,
printing the page, and signing. Then either fax or mail to Gate 1 Travel.
We cannot accept electronic submissions.
|Passenger / Client Name(s):|
|Amount Authorized to Charge: $|
|Cardholder (print name)||
(If not one of the traveling Passenger(s),Card Holder must submit a copy of the front and back of the card) - Please Print
|Type of Card||
____ I have read and understood all terms and conditions including the terms of cancellation policies . My payment and signature below constitute acceptance of those terms.
Fax to GATE 1 at 215-886-2228
or mail to: GATE 1 455 Maryland Dr, Fort Washington, PA 19034