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Friday, 2010-09-03

Fax payment form for credit cards
Fax to: + 66 - 2 - 714 8471
Golfasian.com Co., Ltd
Unit 1707, 29 Bangkok Business Center, Soi Ekamai, Sukumvit 63
Klongtan Nua, Wattana, Bangkok 10110 Thailand
Golf holiday details:
Booking number:
Arrival date:
Departure date:

Credit card details:
Visa Master  Card JCB Card
Name of credit card holder:
Credit card number:
Country of issuing bank:
Name of issuing bank:
Expiry date:
Security verification code (last 3 numbers on the back for VISA/Master)  

Amount to be charged:
Charge following amount to above credit card:
Amount in writing:
Date:
Signature: