Please complete the form, print, sign
Fax to : 00-66-2 629-4714
|Full Name (as on card)||
|Booking reference no.|
|State / County|
|Card Type||Bank Name :|
The last 3 digits of the number on your signature strip
|Please read carefully||
We can only charge cards in Thai baht. Due
to exchange rate fluctuations and
the fact that the actual exchange rate is dictated by your card company, there may be some difference between our quoted equivalent in other currencies and what appears on your card statement. We regret that this unavoidable.
No of passengers
I, the undersigned, authorise my card to be
charged with the stated amount |
in Thai baht. I confirm that all information I have given is true and correct.
|Signature(Please sign after printing)||_____________________________|