Credit Card Payment Form by Siammedee.com (Siammede.com)
Credit Card Payment Form - This is to authorise : Siammedee Business Travel Co., Ltd.,
: Hotel Name

: Period of Booking

: Booking under the name

: Credit Card Type (VISA, MASTER, JCB, AMEX CARD only)
: Credit Card Number
  : Credit Card Issuer
  : Country
: Cardholder's Name
: Expiry Date
: The last three digit number (Appearing on the credit card signature panal)
: Batch Code (4 digit no. - AMEX only)
: Passport Number or Indentity Card Number, And Issuer
: To Debit Baht
  : Cardholder's Signature
  : Date
 
Kindly print this form, fill-in your Credit Card details and fax it to our Bangkok Office at (66-2) 250-6324 attn. Ms.GiGi

If you have any suggestions or comments, Please contact us at send an enquiry.
Siammedee Business Travel Co., Ltd. TAT TRAVEL LICENSE No. 11/4190 Bangkok Office : 9.00 am. - 6.00 pm. (Mon-Fri)
Address : 555/8137 Pratunam Center, Room No.2137 Rajprarop Rd., Rajthevee, Bangkok 10400 Thailand.
Tel : (66 2) 309 8137 Fax : (66 2) 250 6324 © Copyright siammedee.com All rights reserved.