Fax Form
 
Please print this form, complete and fax to reservations on +66 76 240 750
booking ID .....................................................................  
your email .....................................................................  
your fax number .....................................................................  
your telephone number .....................................................................  
name ..................................................................... as shown on credit card statement
address (line 1) ..................................................................... as shown on credit card statement
address (line 2) .....................................................................  
city .....................................................................  
country .....................................................................  
credit card number .....................................................................  
credit card type JCB Master Card Visa  
credit card cvv
(for VISA and MasterCard only)
..................................................................... CVV is the last 3-digit number on the signature area of the card
credit card expiry date .....................................................................  
amount to pay .....................................................................  
currency US$ Thai Baht  
I authorise Guide Vision Limited to process the payment for my booking.
card holder's signature ...................................................................as it appears on credit card
date .......... /.......... /..........
comment
...................................................................................................................................................................
...................................................................................................................................................................
we will confirm receipt of this fax within 24 hours.
if you do not receive this confirmation please contact us.
address: 9/98 Rasadanusorn road,Rasada, Muang Phuket 83000 Thailand
telephone: +66 76 240 170   facsimile: +66 76 240 750   email: info@guiderooms.com