Planetfone Rental Application

* Denotes Required fields

First Name*	Last Name*
Company
Shipping Address*
City*	State*	Zip*
Phone*	Fax
Email*

For your own protection, if your Shipping Address and Billing Address do not match your order may be placed on hold until we can validate your information.
Credit Card Billing Address*
City*	State*		Zip*
Phone		Fax

Phone Delivery Date*
/ /

Activation Date*
/ /

Activation and start of rental date will begin one day after the delivery date of the rental phone.

Return Date*
/ /

Select Shipping Method
Must be submitted before 4:00 p.m. Pacific standard time for Overnight Shipping.

If you are going on a cruise please check this box

Check here if you want the package to be left without your signature. If you mark "Yes", then you are accepting full responsibility for the phone and all calls made from the phone.

....Optional - Check here for your 800 Toll free Number what's this

Limit of one cellular phone per Trafalgar Tours Passenger. Please place a separate order for each Trafalgar Tours Passenger requesting this benefit.

Please list all of the countries you will be visiting
Country 1	Country 2	Country 3

Country 4	Country 5	Country 6

Country 7	Country 8	Country 9

Country 10

Special instructions or notes.

AAA Travel Agent Name (If Applicable)

Please enter your 3 Digit AAA Club code and your 9 digit Member number without spaces or dashes
Club Code AAA Member Number

Trafalgar Tours Passenger Booking No.*

I authorize PLANETFONE to use the following card to pay for my cellular phone Airtime and any rental fees and insurance fees over and above the AAA Trafalgar Tours Benefit.

Master Card VISA Card American Express Discover

Credit Card Number *

Exp. Month*

Exp. Year*

(1234)

(5678)

(9012)

(3456)

Ex. (Feb = 02)
(2 Digit Year)

Ex.(2006 = 06)
(2 Digit Year)

For security purposes, please include the 3 or 4 digit security code (found on the back/front of your card) :

3/4 Digit Code*

Name on Card*

Credit Card Authorization:

PlanetFone will take an authorization from your credit card. This is not a deposit, but only a hold on the funds, lasting between 24-72 hours depending on the issuing bank. PlanetFone maintains the right to charge and reauthorize your credit card each time your account balance reaches the authorization amount of $300.00.

Please Note: All prices are in U.S. Dollars. Applicable U.S., State, and foreign taxes, including Value Added Taxes in certain countries such as Japan and Korea, are not included, are additional; and will be added. Rates are subject to change without notice.

Please Note: A $75.00 cancellation fee will be charged if a phone order is cancelled after we ship.

Statement of Authorization:
I hereby authorize PLANETFONE to bill all cellular phone Airtime and any rental fees and insurance fees over and above the AAA Trafalgar Tours Benefit to my current credit card as directed above. If approved, I understand that any charges billed to my designated credit card will be subject to other charges that appear on the account in accordance with the terms and conditions governing the account. Each time I rent a cellular phone, it will be subject to a credit card authorization before my reservation is confirmed and the cellular phone kit is delivered. If I cancel my order, I agree to pay any incurred costs and cancellation fees. If my card status changes, or if my card is lost or stolen, I agree to notify PLANETFONE and the appropriate credit card company immediately. If I elect to terminate this credit card authorization to bill my account, I will notify PLANETFONE and the appropriate credit card Company.

Indicate here as having read, understood, and agree to the Terms & Conditions
Print Name:*	Today's Date:* / /

* Required Field

101 Convention Center Drive, Suite 700
Las Vegas, Nevada 89109
Toll Free: (888) 482-4222
Fax: (888) 388-4800
Email: PlanetFone

PlanetFone Terms and Conditions