CREDIT CARD FORM - IMPERIAL MEA PING
To guarantee your booking, please printout this form, fill it out completely all the information and
fax to our reservations fax line Thailand : at (66 2) 541-9574
In case of no show, one night charge will be cherged through your credit card.
Currently we accept Only Visa, Master Amex or JCB cards.

I hereby authorized IMPERIAL MEA PING, CHIANGMAI   to charge the

amount of US$                                                                                         .

from __                                ___ to:                                             

Cardholder's Name :                                                                      (as it appears on card)

Guest's Name :                                                                             (if different from above)

Card Number :                                                                                     

Master Card : write down the last 3 digits show on the back of the card :               

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.