Fax payment
form for credit cards |
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Fax to: + 66 - 2 - 714 8471 |
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Golfasian.com Co., Ltd |
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Unit 1707, 29 Bangkok Business Center, Soi Ekamai, Sukumvit 63 |
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Klongtan Nua, Wattana, Bangkok 10110 Thailand |
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Golf holiday
details: |
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| Booking number: | |
| Arrival date: | |
| Departure date: | |
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Credit card details: |
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Visa
Master Card
JCB Card |
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| 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) | |
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Amount to be charged: |
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| Charge following amount to above credit card: | |
| Amount in writing: | |
| Date: | |
| Signature: | |
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