PAYMENT FORM

Your details

Name:

Address:

Postcode:

Email:

Telephone:

Method of Payment

Card type: Visa/Visa Delta/Visa Purchasing/Mastercard/JCB/Switch/Solo:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Card number:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Valid from:	_ _ _ _
Expiry date:	_ _ _ _
Issue number (Switch & Solo only):	_ _ _ _
Security Code (3-4 digit number printed at the end of the cards’ signature strip:	_ _ _ _
Name on credit/debit card:
Signature:
Date:

Cheques, postal orders or bank drafts should be made payable to ‘Volunteer Latin America’ in pounds sterling only please.

Post to: Volunteer Latin America, PO Box 585, Rochester, ME1 9EJ, United Kingdom