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Authorization to Charge Credit Card by Phone

Whole Foods Market Georgetown does not keep credit card numbers on file. However, we must have a customer profile and written authorization, including signature, in advance to process your credit card over the phone.

Please complete and sign this form:

Cardholder’s Name: ________________________________________________________________

(Exactly as it appears on the credit card)

Credit Card Billing Address:

Street: ____________________________________________________________________________

City: ___________________________________________________ State: ____________

Zip: _______________________

Email : __________________________________________________

Telephone : Home/Cell: (______)________________________

Work: (______)________________________

Fax: (______)________________________

I authorize Whole Foods Market to accept my credit card as a form of payment with my order. I agree to pay the amount under contract with the card issuer. A receipt for this purchase will be delivered with my order.

Card Holder Signature: ___________________________________________

All customer information will remain confidential.

Please complete and return this form in any of the following methods:

Mail / Hand Deliver Email

Whole Foods Market Georgetown inahurrygtn@

Attn: In A Hurry Bike Delivery

2323 Wisconsin Ave.

Washington, DC 20007

We require an original signed form on file in order to process all delivery orders.

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