I hereby authorized  www.asianetonline.com to charge the amount of

BAHT                                                                                  

from __                                ___ to:                                             

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

Guest's Name :                                                                             (if different from above)

Card Number :                                                                                     

Master / VISA - 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 Attn. Miss.Varin E-mail :rsvn@asianetonline.com