Credit Card Form - Suwan Macha Cruise

This is to authorise :

AT NETWORK CO., LTD., THAILAND

To debit Baht..........................................for Suwan Macha Cruise

Against Credit Card Type : ........................................................
(ONLY VISA, MASTER, JCB, AMEX CARD)

Credit Card No : ..........................................................................

Cardholder Name : ......................................................................

Expiry date : ................................................................................

Signature of Cardholder : ..........................................................

Date : ...........................................................................................

*********************IMPORTANT*********************

Please kindly print this form, fill-in your Credit Card details and
fax it to our Bangkok Office at (66-2) 677-6246 to 7.
PLEASE ATTENTION TO JULIA.