Credit Card Authorization Form

This form may be used at any time to make a payment on existing reservation only.

If you’re making a new reservation please use the Travel Registration Form.

Refer to your invoice or any information received from us for balances and payment due dates. For payment related questions please contact us at 410-497-7105 or at travel@bellesabound.com

Booking #*
Payment Information
Please enter the amount to be charged on the card.
Amount*
Enter amount in USD, do not include the dollar sign. (For example: 250.00)
Name on Credit Card*
Credit Card Type*
Visa Card Number*
MasterCard Number*
Discover Card Number*
American Express Card Number*
Expiration Month*
Expiration Year*
Security Code*
Billing Information
Address*
Street Address Address Line 2 City State ZIP Code
Mobile Phone*
Email*
Additional Information
Please add any optinal information to explain your payment.
I hereby authorize Belles à Bound to charge my credit card for the amount above to make a one-time payment toward my outstanding balance for the booking above.*
Please enter your name. This will serve as your electronic signature - the equivalent to signing your name on a printed credit card authorization slip.
Date*
MM slash DD slash YYYY

If you have trouble processing your payment online or would like to pay by credit card over the phone, please call 410-497-7105 during business hours Monday – Friday, 9:00 AM-7:00 PM Eastern Standard Time or email us directly at travel@bellesabound.com. We also accept other forms of payment including checks and money orders at our mailing address:

Robin Chambers
PO Box 11228
Baltimore, MD 21239

Credit Card Authorization Form

This form may be used at any time to make a payment on existing reservation only.

Payment Information

Billing Information