Credit Card Payment Form

To guarantee your booking, please printout this form, complete all the information and fax to 66 (2) 2170109 => We only accept VISA, MASTER, AMEX and JCB cards

I hereby authorized	>---- Select Hotel Name -----> ASIA HOTEL BANGKOK  ASIA PATTAYA HOTEL ASIA AIRPORT HOTEL
to charge my credit card for the accommodations
Date Check In Date Check Out
Total Amount in Thai Baht :
Cardholder's Name :		(as it appears on card)
Guest's Name :		(if different from above)
Card company :	>------- SELECT CARD -------> VISA CARD MASTER CARD AMEX CARD JCB CARD
Card Number :
Expiry date :	Country :
Please write down the the last 3 digits show on the back of the card :
Billing Address :
SIGNATURE : ___________________________ Date : _____________________

Remarks :

1. For 1 - 3 rooms
1.1 )	Requested Room will not be guaranteed without guest's signature on this payment form.
1.2 )	One night guarantee is required. The charge will be exercised only in case of No-Show
	or cancellation less than 72 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.
2. For the group of 4 rooms or more
2.1 )	A non - refunable deposit of total Amount is required.
2.2 )	No refund for group cancellation.
3. There may be some additional conditions during some peak periods.