Please printout this form,
fill it out completely all the information and fax to our reservations fax line Thailand : at (66
2) 541-9574
Full payment will be charged through your credit card after reservation is confirmed.
Currently we accept Only Visa,
Master Amex or JCB cards.
I hereby authorized WWW.ASIANETONLINE.COM to charge the amount of
______________________________________________________
for transfer / accommodation at the hotel : ___________________________________
Period from ___________________________ to: ___________________________
Cardholder's Name : _______________________________________(as it appears on card)
Guest's Name : ___________________________________________(if different from above)
Card Number : __________________________________________________
Master/VISA Card - the last 3 digits show on the back of the card : _______________
AMEX - 4 digits code :_________________ Expiry date : _________________
Card company : _______________________ Country: ______________________
SIGNATURE : ____________________________ Date : ____________________
*********************** IMPORTANT **********************
Please
kindly print this form, fill-in your details and send us via fax at
(66 2) 541-9574
or E-mail :rsvn@asianetonline.com Attn Miss Varin
