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CREDIT
CARD FORM -DUSIT RESORT PATTAYA
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 the reservation is confirmed. Currently we accept Only Visa, Master Amex or JCB cards. ) |
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I hereby authorized DUSIT RESORT, PATTAYA to charge the amount of BAHT .
from
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to:
Cardholder's Name : (as it appears on card) Guest's Name : (if different from above) Card Number : 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  |