Credit Card Authorisation Form - by Fax
Please print this form, fill it out completely, and fax it back to us.
Fax No. + 66 2 435 7515
I wish to pay by : |
|
I hereby authorise Asian Splendour Holidays Ltd
to charge ................................. to my credit card.
| Cardholder's Name : as it appears on card |
|
| Card Number : | |
| Expiration Date : | |
| Cardholder Statement Address : |
|
| Pay for Invoice No : | |
| Signature : as it appears on card : |
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e-mail : tourdesk@ash-hotel.com
website : http://www.ash-hotel.com
147/58 Pinklao Nakhorn Chaisri Road
New Southern Bus Terminal - Bangkok 10700 Thailand
Tel: (662) 435 7514, 423 2263 ( 5
lines auto ) Fax: (662) 435 7515