I hereby authorized www.advicehotel.com 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 :booking@advicehotel.com