<p> Credit Card Authorization Form</p><p>By completing this application and signing this form or using the digital signature box below, I hereby authorize MAFSI to apply charges directly to my credit card as specified below. Please type directly onto form. </p><p>Send completed form to [email protected] or fax to 888-254-0033</p><p>Company Name: </p><p>Description of Charges (Check as Applicable):</p><p>$550 - Bondurant Racing School – Saturday, January 16 – 8:00 am – 1:00 pm</p><p>Name of Cardholder: </p><p>Address of Cardholder: </p><p>Phone Number of Cardholder: </p><p>Credit Card Information</p><p>Amount Credit Card: Credit Card VISA # MasterCard Amex Exp. Date Security Code Signatur Click X to sign if electronic: Date: e: ______</p><p>MAFSI 1199 Euclid Avenue Atlanta, GA 30307 404-214-9474 – Phone 888-254-0033 – Fax [email protected] www.mafsi.org</p>