UNIVERSITY OF THE VIRGIN ISLANDS 
CREDIT CARD AUTHORIZATION 
 
 
Appeal/Events: 
 
 
 
Credit Card # ________________________  
Expiration Date: ________________ 
 
 
 
VISA ______ MASTERCARD _____ 
AMEX _____ CID # ____ 
 (Note: AMEX cardholders places include 4-digit CID Number on right side of card.) 
 
By signing below, I assume full responsibility for this credit card transaction. 
 
For ________________________________ in the amount of $ ____________________. 
 
Alumni/Friend Name 
 
 
____________________________________ 
______________________________ 
Print Name of Card Holder 
 
 
 
 
Date 
 
 
 
_____________________________________ 
 
Signature of Card Holder 
 
Mailing Address: _________________________________________________________ 
 
 
 
___________________________________________________________ 
 
Telephone: 
Work _____________________ 
Home ________________________ 
 
 
 
Mail completed form to: 
 
University of the Virgin Islands 
 
Alumni Affairs Office 
 
2 John Brewer’s Bay 
 
St. Thomas, VI 00802-9990