Ventas, Producción, Importación y Exportación de Flores Frescas y Productos Relacionados.

Sells, Production, Import and Exportation of  Fresh Flowers and Related Products.

 

 
 

CREDIT CARD AUTORIZATION FORM

Full name as stated on your credit card:

Full Address:

Telephone/Fax:

E-Mail:

Card Type:

Number:

Expiration
Date:

Order Description:

Issuer Bank:

Date Of Delivery:

Recipient Name:

Full Address:

Phone:

Card Message:

Add Card To The Flowers:

Do hereby authorize Rosas Candia (Agropecuaria Candilejas, C.A.) and/or it´s officers to charge my above mentioned credit card for the amunt of bolivars:

Signature: (As is on your credit card)

Print and send by fax to:  58-212-3727485

 
Copyright © 2002 AGROPECUARIA CANDILEJAS, C.A.
Última modificación: 31 de agosto de 2003