PLEASE DOUBLE CHECK YOUR INFORMATION ABOVE BEFORE SUBMITTING YOUR PAYMENT REQUEST. Do not leave any boxes blank. 
Once you hit the 'submit' button below, if the submission goes through you will be taken to a page that says: Thank you for submitting a payment request.

Thank you for being a valued client!

REQUEST FOR PAYMENT

Disney requires a cc to book select dining reservations and other special requests. Your DVP will keep this card on file unless you type "NO" below.

Credit Card Number *

Phone *

Payment Amount *

City & State *

Zip Code *

Credit Card Expiration Date *

3 (or 4) digit security code on back of card *

Date of payment:

Please include any additional comments that will help your DVP process your payment properly - including additional payments if submitting multiple.

Who is your assigned Dream Vacation Planner? Include first and last name (or last name initial). *

Your Name: This is YOUR ELECTRONIC SIGNATURE allowing a one time credit card payment authorization as instructed above. By completing and submitting this form you are authorizing a payment(s) to the credit card listed. You give permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account. Please type YOUR NAME in the box below to authorize. *

Destination of your vacation: *

Name as shown on credit card

Email: *

Name: *

Street Address *

Country

One Time Credit Card Payment Authorization Form - By completing and submitting this form you are authorizing a payment(s) to the credit card(s) listed below. You give permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account.

Reservation confirmation # (or check in date) *

PIXIE & PIRATE DESTINATIONS

Send your payment securely. 

Use our SECURE site to submit your credit card information for processing of deposits, payments, ticket purchases and guarantees for your dining reservations. Allow up to 48 hours for your payment or deposit to be processed. If this is time sensitive, email or call your PAPD Dream Vacation Planner (DVP) after you submit this information via the website. 
To process your payments your DVP will need the following information: *Type of CC 
*Name on CC 
*CC number 
*Expiration date 
*Billing address and phone 
*Amount of payment 
Please fill out the Request for Payment form below to proceed with submitting a payment request.

If you would like to have a deposit/payment processed for your current reservation (or courtesy hold) please fill out the following request. The payment request will be sent to your personal DVP and they will process your payment. THIS IS NOT AN AUTOMATIC PAYMENT. YOUR DVP WILL HAVE TO PROCESS THE PAYMENT FOR YOU.

Please allow up to 48 hours for your payment to be processed. If this is a time sensitive matter please submit this request and then contact your personal DVP directly with your time sensitive information.

This form may also be used to purchase tickets, submit a credit card for dining reservation guarantees, special requests such as the BBB or Pirates League, etc. Please notate the reason for your submission in the comment section if needed.

The form submission does not work wellon some mobile devices or tablets. Please use a computer to submit your payment request. Once you submit your payment request you will be directed to a confirmation page. Again, if there is a concern about a payment or a payment submission, please contact your DVP directly.