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AC Travel Payment Form
Have your itineraries ready & booking reference to complete transaction www.actravel.co.nz
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1
First Name:
*
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2
Last Name:
*
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3
E-mail
*
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4
Contact Number:
*
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5
Booking Reference:
*
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6
Survey: How did you know about us?
Facebook
Instagram
Friends Referral
Events/Conference/Meetups
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7
Payment Transaction
*
This field is required.
Please check the total amount quoted by the AC Travel Agent. We accept Credit Card| Qcard | American Express | Mastercard Visa | Gem Visa
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( X )
Total Amount
NZD
+ OR enter a custom value
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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AC Travel Pay Form
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