I hereby authorized THE PARK HOTEL, CHIANG MAI to charge the

amount of THAI BAHT                                                                                    .

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 fax it back to our Bangkok Office at
(66 2) 541-9574 Att. Miss Varin E-mail :rsvn@asianetonline.com
Remarks : The charge will be exercised only in case of No-Show or cancellation less then 48 hours
before arrival. If guests come to stay in the hotel, this charge will be cancelled and guests have to pay
in full amount at the hotel.