Credit Card Authorization
CANOPY TOWER
PANAMA     
Today's Date: __________

I ____________________________________________________________
(Please Print Cardholder's Name exactly as it appears on the card) 
Authorize Canopy Tower to charge my credit card (choose one): 
______Visa ____MasterCard

Card Number _________________________ Exp. Date ________
Security Number ________ 
(3 digits found on back of Visa and MC)

The amount of US$_________
(please also write amount in letters):
_______________________________________________________________ 

This charge corresponds to:
Non-refundable deposit                        $___________ 
1st Payment 60 days before scheduled arrival  $___________
2nd. Payment 30 days before scheduled arrival $___________ 

I am paying for the following services (lodging, transportation, tours): 
________________________________________________________________

Name of Guest(s): ______________________________________________
Arrival Date: _____________
Departure Date: ___________
Telephone: (      )__________________ 
E-mail: ___________________________________________ 
   
________________________________________________________________
(Cardholder's Signature)

Please send this page with full information to our US Toll free
fax (800) 854-2597 or Panama fax 011 (507) 263-2784 

Important notice:

We are very sorry but, due to the high commissions charged by credit
card companies, there will be a 3% add-on for the use of credit cards. 
If you do not wish to pay this charge, please send by registered air
mail a US$ check in favor of Canopy Tower to: 
Canopy Tower
Apartado 0832-2701 WTC
Panama, PANAMA
Please also include a copy of this form properly filled out.

Payment by check is accepted if your arrival date is more than 45 days
from today. Otherwise, you have to pay by credit card.

Thank you very much; we appreciate your understanding and support.