Credit Card Authorization Credit Card Authorization Setup Authorization I, representing authorize the use of my Select Card Type Personal Company Credit Card for payment on behalf of: Guest or Function Name: Phone: Properties Best Western KelownaDelta Lodge at KananaskisFSJ/BC and RegionGaming Chances Fort St JohnGP/AB RegionGrande Prairie Pomeroy Hotel & Conference CentreHoliday Inn Express - Grande PrairieHoliday Inn Express -Ft. St. JohnHotello - VegrevilleMotel 6 - Grande PrairieMount Kidd ManorPomeroy Hotel & Convention Centre Ft. St. JohnPomeroy Inn & Suites - ChetwyndPomeroy Inn & Suites - Dawson CreekPomeroy Inn & Suites - Fort St. JohnPomeroy Inn & Suites - GrimshawPomeroy Inn & Suites - VegrevillePomeroy Inn and Suites - OldsPomeroy Inn and Suites INCPomeroy Inn and Suites VermilionRamada Inn - ClairmontStonebridge Hotel - Dawson CreekStonebridge Hotel - Ft. St. JohnStonebridge Hotel - Grande PrairieStonebridge Liquor Store Authorized Charges Room & TaxGuest Laundry ServicesGuest MealsDry Cleaning ServicesAlcoholic BeveragesCateringLong DistanceOtherPay Per View MoviesSecurity Deposit $50.00 Other Charges: Comments Credit Card Details Card: Select Card Type Visa Master Card American Express Credit Card #: Name on Card: Expiry Date: 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December / 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 Any questions about this card please contact Name: Phone: Email: Authorization Terms Date of Authorization: This authorization is to remain in effect for a given time period - This authorization will be renewed as required for similar time periods OR This authorization is to be ongoing until canceled, in writing by the card holder or their designate. Be advised that in the event of the Expiry of this Credit Card, it will be the responsibility of the Credit Card holder to reissue/update the above Credit Card Authorization. Be advised that by registering your credit card information to the pci system it does not constitute a reservation at the selected hotel property. You must still contact the hotel directly to book your reservation needs via the following options; by phone, hotel website or your travel agent. I have read and agree with the terms and conditions above.